Should you be worried about the latest round of H3N2 flu?

The Indian Express | 1 week ago | 18-03-2023 | 01:45 pm

These days we are barraged with a bewildering array of alphanumerics: H3N2, H2N2, H1N1 and of course the unforgettable SARS-CoV-2. These combinations are complex enough to serve as highly secure passwords to enter our bodies’ operating systems, lull us into complacency, terrorise us with déjà vu or possibly even all of the above. Should we be worried?Influenza viruses have co-existed with humanity at least since 6,000 BC in China, with Greek writings of fifth century BC indicating illness descriptions that match influenza. However, the influenza virus was first discovered only in 1931 by Richard Shope as a cause for swine influenza, a new disease among pigs at the time. By 1933, influenza A viruses were identified as being responsible for human infection, with multiple subtypes being discovered in subsequent years. Influenza B was discovered in 1940, and Influenza C and D were identified thereafter.The mother of all pandemics, The Spanish Influenza of 1918-1919, was caused by one such virus. It resulted in over 100 million deaths, the equivalent of 480 million deaths today. The 1957-58 Asian flu pandemic caused by the H2N2 virus resulted in over two million deaths, the equivalent of about 7.5 million deaths today. The 1968 Hong Kong Flu pandemic caused by the H3N2 virus resulted in over a million deaths. The 2009 Swine Flu pandemic caused by the H1N1 virus resulted in half a million deaths. We are all too familiar with the ongoing COVID-19 pandemic caused by the SARS-CoV-2 virus which has already resulted in approximately eight million deaths. All these viruses have mutated into less lethal avatars, which are gallivanting across the globe, resulting in several million infections and more than a million deaths every year. So, why shouldn’t we be worried?First, these are all weakened viruses with varying degrees of infectivity but very low rates of lethality. Next, the RT-PCR test has now become sophisticated enough to detect these viruses. Third, we have effective vaccines. Fourth, we’ve learnt a few things from experience.In late December 2022 and early January 2023, an outbreak of a respiratory infection with symptoms of a cold, sore throat, fever, and weariness was noticed within India. On March 4, the Indian Council of Medical Research (ICMR) announced that the disease had been caused by influenza virus subtype H3N2, a virus made of the N2 from the 1957 H2N2 virus and the H3 from the Avian Influenza A virus.COVID-19, as we know only too well, is brought on by the SARS-CoV-2 virus. The symptoms of all flu variants and those of COVID-19 are fairly similar. They include fever, stuffy nose, sore throat, fatigue, and headache. There are minor variations in predominance of symptoms and in recovery periods ranging from one to two weeks. Laboratory testing with the new RT-PCR tests is necessary for a precise diagnosis in order to pinpoint the genetic or molecular elements of the virus. Testing certainly helps on an epidemiological level to track and monitor disease prevalence but is of minimal significance in formulating an individual’s treatment plan.We are currently dealing with at least four, possibly more influenza viruses in addition to SARS-CoV-2. All of them are contagious and spread through droplets. Hence the prevention of all of them is similar. Precautions that reverberated as slogans during the COVID-19 pandemic plead to be re-established. Use of masks, hand and respiratory hygiene and social distancing are the best measures to curb the spread of all four viruses. I haven’t given up yet on masking and hand hygiene much to the amusement of many of my friends and some colleagues. Then again, call it luck, genes, vaccination, appropriate protocols, or combinations thereof but I have been spared COVID-19 and flu in all these years.What does one do if ill other than the obvious medical consultation? Bed rest, isolation, hydration, ventilation and symptomatic treatment for fever, sore throat, body ache, cough and other symptoms. Hospitalisation may be considered if not better in 7-10 days and deemed necessary by one’s physician. But unless there is secondary bacterial infection, absolutely no antibiotics. Certainly not the ones recommended by the friendly neighbourhood chemist! Antibiotics do not work on viruses. On the other hand, they do an incredibly sinister job of fostering antibiotic resistance which is growing to become a monumental problem in healthcare. Please avoid them unless deemed necessary by your physician. If indicated, antiviral drugs such as Tamiflu are known to facilitate recovery.One cannot help wondering if Lord Gautam Buddha might have anticipated the romp of multiple viruses when he advocated the golden middle path? Between recklessness and excessive caution, untampered bravado and paralytic anxiety, audacity and timidity lies our salvation.

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Why 2020-2030 has the makings of a lost decade for the global economyPremium Story

The Indian Express | 1 day ago | 29-03-2023 | 01:45 pm

The Indian Express

1 day ago | 29-03-2023 | 01:45 pm

ExplainSpeaking-Economy is a weekly newsletter by Udit Misra, delivered in your inbox every Monday morning. Click here to subscribeDear Readers,From the perspective of the global economy, the year 2023 started off on a mildly optimistic note. As top policymakers and CEOs met in Davos, there was a sense that the global economy might be able to dodge the chances of a recession in 2023. The IMF’s World Economic Outlook in January provided a salutary stamp to that notion. However, the recent collapses in the banking sector had yet again ratcheted up the apprehensions of a recession.In this context, a new research publication by the World Bank, titled “Falling Long-Term Growth Prospects”, argues that the current decade (2020-2030) “could be a lost decade in the making—not just for some countries or regions as has occurred in the past—but for the whole world.”Simply put, the World Bank has found that the overlapping crises of the past few years — Covid-19 pandemic, Russia’s invasion of Ukraine and the resultant spike in inflation as well as monetary tightening — have ended a span of nearly three decades of sustained economic growth.“Starting in 1990, productivity surged, incomes rose, and inflation fell. Within a generation, about one out of four developing economies leaped to high-income status. Today nearly all the economic forces that drove economic progress are in retreat,” writes David Malpass, President, The World Bank Group.He further warns that without a big and broad policy push to rejuvenate it, the global average potential GDP growth rate—the theoretical growth rate an economy can sustain over the medium term based on investment and productivity rates without risking excess inflation— is expected to fall to a three-decade low of 2.2% a year between now and 2030, down from 2.6% in 2011-21 and 3.5% during the first decade of this century.The important thing to understand here is that while the report talks about global growth slowdown, the main hurt will be felt by emerging economies such as India. “A persistent and broad-based decline in long-term growth prospects imperils the ability of emerging market and developing economies (EMDEs) to combat poverty, tackle climate change, and meet other key development objectives,” states the World Bank.The World Bank report recounts a 2015 research request by Kaushik Basu, the World Bank Group’s Chief Economist at the time, to assess the long-term growth prospects of emerging market and developing economies (EMDEs).While the World Bank came up with a preliminary study (titled “Slowdown in Emerging Markets: Rough Patch or Prolonged Weakness?”), the latest publication provides “a definitive answer” to the question. And the answer is: These economies are in the midst of a prolonged period of weakness.Look at the data for actual GDP growth and per capita GDP growth in the two tables (A.1 and A.3) below. It shows a broad-based decline over the past two decades whether a country belongs to EMDEs or the middle-income countries (MICs) or the low-income countries (LICs).The World Bank has looked at a whole set of fundamental drivers that determine economic growth and found that all of them have been losing power. The six charts below capture the weakness.These fundamental drivers include things like capital accumulation (through investment growth), labour force growth, and the growth of total factor productivity (which is the part of economic growth that results from more efficient use of inputs and which is often the result of technological changes) etc.Not surprisingly then, the potential growth rate is expected to decelerate further (see Table A.3).What about India?Even though India has also lost its growth momentum over the past two decades, it is and will likely remain a global leader when it comes to growth rates. India falls under the South Asia Region (SAR), which is expected to be fastest growing among emerging market and developing economies (EMDEs) for the remainder of this decade. To be sure, India accounts for three-fourths of the SAR output. SAR includes countries like Afghanistan, Pakistan, Sri Lanka, Nepal and Bangladesh etc.“Economic activity in the South Asia region (SAR) rebounded strongly from the recession caused by the COVID-19 pandemic, expanding by 7.9 percent in 2021 after a drop of 4.5 percent in 2020. Output in the region is on track to grow by about 6.0 percent a year between 2022 and 2030, faster than the 2010s annual average of 5.5 percent and only moderately slower than growth in the 2000s,” states World Bank.According to the World Bank, if all countries make a strong push, potential global GDP growth can be boosted by 0.7 percentage point—to an annual average rate of 2.9%; this would be faster than the preceding decade (when the global economy grew by 2.6%) but still slower than the first decade of 2000s (when the growth clocked 3.5% per annum).There are six priority interventions suggested by the report: incentivise investments into the economy, boost labour force participation rates (especially for women), cut trade costs, capitalise on service exports, improve global cooperation, ensure that fiscal policies and monetary policies don’t run against each other (for instance, government expenditures raising deficits at a time when central banks are trying to contain inflation).Until next week,Udit

From PSL vs IPL to political chaos and a ‘less festive’ Ramazan: What the Pakistani media is talking about

The Indian Express | 4 days ago | 26-03-2023 | 01:45 pm

The Indian Express

4 days ago | 26-03-2023 | 01:45 pm

PSL success, continuing political chaos and rising Covid numbersThe three prominent domestic issues in the news in Pakistan are the delayed elections, rising Covid numbers and a the successful Pakistan Super League cricket tournament.The Election Commission of Pakistan (ECP) has decided to delay the Punjab and Khyber Pakhtunkhwa elections until October. The Nation (March 24) is sympathetic to the ECP: “The ECP also finds itself in a tough spot given that the Army has said that it will not be available for poll-related duties in light of the security situation.” Express Tribune (March 24) says, “the top court will strike down the electoral watchdog’s decision to postpone election as ‘constitutional overreach’.” Dawn (March 24) heavily condemns this decision saying, “If the ECP does not reverse its decision, the precedents being set are going to damage Pakistani democracy, perhaps irrevocably so.Dawn (March 25) welcomes the WHO’s announcement that “the virus… won’t be viewed any longer as one that is ‘disrupting society and hospital systems’”. But they caution the public saying, “in a country like Pakistan, which has one of the world’s highest rates of diabetes, officials must continue to urge vigilance.” The Nation (March 25) says, “a new wave… is bound to cause irrecoverable damage” for Pakistan, which is “already suffering from a never-ending political crisis and economic turmoil”.The Lahore Qalandars made history by becoming the first team to win the tournament for their second consecutive year. Express Tribune (March 20) began by comparing the PSL to the IPL saying, “It was comforting to learn that the PSL had surpassed the Indian Premier League on digital rating”. News International discussed the highlights — recounting the contribution of particular players and said, “The series was a precursor for a PSL-style women’s T20 league which Pakistan plans to launch next year.” Dawn (March 20) added that the “PSL went on despite the unrest in Lahore, not only showcasing Pakistan’s ability as a cricket host but also helping to divert people’s minds from cantankerous politics.”The ‘elusive’ IMF dealIn economic news this week, the IMF deal and food and fuel crisis — especially during Ramazan – were discussed.On the cost-cutting measures that have caused severe hardship for ordinary Pakistanis, Daily Times (March 25) said, “It is more crucial than ever before to think long-term and establish institutions that can protect vulnerable groups amid all the brutal belt-tightening measures we’ve seen this year”. The IMF has added another measure before signing the deal, which is increasing the interest rate to the recommended 4 per cent. The Nation (March 24) calls the IMF programme a “necessary evil” and says “it is clear that the government is trying its hardest to retain some control over monetary and fiscal decisions… but we are running out of options”. Dawn (March 25) says, “the decision-makers sitting in Islamabad… remain unable to convince the IMF… to bail the country out of its present crisis”. It adds that the IMF too seems to be “acting in bad faith… cynically using the delays in reaching an agreement for political mileage”.The prevailing narrative around the petrol subsidy is that this is a “last-ditch effort” and that “populist solutions to the problems faced by the people always prove untenably expensive for the economy” (Dawn, March 21). News International (March 22) talks about it keeping in mind the general elections right around the corner saying it may be to “sweeten the ballot box” but that “canvassing for votes based on dubious conspiracy theories or ill-conceived schemes masquerading as pro-poor subsidies is a no-no.” Express Tribune (March 21) says, “the desire to come up with subsidies and relief to the neglected and low income segments of the society is appreciated” but the lack of “quantified data to estimate the needful requirement” makes it less effective.The Nation (March 25) says, “With gas in short supply, residents have a hard time preparing for sehri and iftar”. They attribute this shortage to a “lack of care in using our gas reserves”. Daily Times (March 24) says, “purchasing power of the average Pakistani has gone down by 40 per cent this year” and so, Ramazan “this year is less festive”.Amritpal, defamation and Rahul GandhiOn India this week, there was much said about the Amritpal matter, on defamation and Rahul Gandhi.Express Tribune commented on both the Amritpal case (March 22) as well the defamation issue (March 25). It cautioned India against a “return to the 1980s Sikh militancy era” and “the fundamentalist Hindutva movement’s assault on Indian secularism has bred fundamentalist sentiment in minorities” and “if not addressed, the hateful ideology will end up tearing India apart.”On the Rahul defamation issue, Express Tribune says, “the law appears to have been applied vindictively in this case” but it offers “food for thought regarding Pakistan… if prominent leaders actually had to think twice before accusing their opponents”, they “would have to speak on policy strengths and weaknesses, rather than scandal and slander”.Daily Times (March 26) commented on Rahul Gandhi’s case saying, “for a mainstream politician having his career overwhelmed by a conviction that has sent shockwaves in all quarters over its regressive nature… we, at Daily Times, could only offer profound regrets”. It adds that “Modi’s administration has gained considerable notoriety… for using the law to silence its dissidents.” The editorial concludes by saying, “the writing on the wall asks of everyone: beware, beware, for the colonial boogeyman is here.”adya.goyal@expressindia.com

SC directs prisoners released during Covid pandemic to surrender within 15 days

The Indian Express | 6 days ago | 24-03-2023 | 01:45 pm

The Indian Express

6 days ago | 24-03-2023 | 01:45 pm

The Supreme Court on Friday directed all convicts and undertrial prisoners released during the Covid-19 pandemic to surrender within 15 days.A bench of Justices MR Shah and CT Ravikumar said undertrial prisoners, who were released on emergency bail during the pandemic, can move for regular bail before competent courts after their surrender.The bench added that all the convicts who were released can move competent courts for suspension of their sentence after their surrender.Several convicts and undertrial prisoners, mostly those who were booked for non-heinous offences, were released during the pandemic in an effort to decongest jails.  This move happened in various states on the recommendations of high-powered committee set up in pursuant to directions of the apex court.(With PTI inputs)

Amid Covid, H3N2 rise, how India can help build global resiliencePremium Story

The Indian Express | 1 week ago | 23-03-2023 | 01:45 pm

The Indian Express

1 week ago | 23-03-2023 | 01:45 pm

The recent rise in Covid-19 cases reminds us that the pandemic is not yet over. It has added some more concern to the ongoing influenza outbreaks. On the global stage, countries and a range of institutions are negotiating the “pandemic treaty” — a global accord on pandemic prevention, preparedness and response.As is reasonably well known now, the Covid XBB 1.16 variant seems to be fuelling the surge, nearly a three-fold rise in cases over the last fortnight. So far, it has not caused any mortality in India. With more than 6,000 currently active cases, 76 samples of XBB 1.16 have tested positive from eight states, the most so far from Karnataka and Maharashtra. XBB.1.5 has been reported from 38 countries and declared a variant of interest (VOI) by the WHO. It is expected to emerge as a dominant strain in the UK and Europe and is rapidly spreading in the US as well. Even individuals who had received three or four doses of an mRNA vaccine (such as Moderna or Pfizer), plus suffered a BA.5 infection, were not immune to this variant. There is no evidence of any potential change in severity though. The growth advantage of XBB 1.16 is nearly one-and-a-half times of XBB.1.5, making it a rather aggressive variant, and with immune escape properties too.Another potential worry from Israel is the identification of a combination of the BA.1 (Omicron) and infectious BA.2 variants. The virus was detected in the parents of an infant boy, in whom two viruses linked up and exchanged genetic materials. The current test positivity rate is 10 per cent, a worrying metric by all accounts.This current landscape of Covid-19 is layered with a huge surge of H3N2 Influenza A cases, with at least nine reported deaths. Influenza B has also been identified. Both these are seasonal influenzas, driving up the hospital — including intensive care — admissions. Much like Covid-19, the high-risk groups are pregnant women, the elderly and those with chronic medical conditions and immunosuppressive conditions. Healthcare workers are at particularly high risk of getting affected and in turn spread to vulnerable persons.The limitations of the International Health Regulations (IHR) 2005 were exposed during the Covid-19 pandemic — both in countries not reporting in time and the international agencies not responding adequately. Local, national and global governance is increasingly being recognised as an important determinant of the emergence and re-emergence of diseases of animal origin. To re-emphasise, both Covid-19 and the influenza viruses have animal origins — “spill over” in technical jargon — when a virus is able to overcome several barriers to “jump” and become feasible in another species.It is in this context that the World Health Assembly set off a global process in December 2021, at its second-ever special session, to draft and negotiate a convention agreement to strengthen pandemic prevention, preparedness and response. An intergovernmental negotiating body (INB) that includes WHO’s 194 countries is steering this process. At the same time, more than 300 amendments to the IHR are also being discussed. The World Health Assembly in 2024 is expected to ratify these, ushering in a “comprehensive, complementary and synergistic set of global health agreements”. The WHO Director-General referred to this initiative as a once-in-a-generation opportunity to strengthen the global health architecture to protect and promote the well-being of all people.The G20 group of countries, with the Indian presidency, has a significant role to play. This is particularly so in light of the One Health Mission that India is working on and is expected to be rolled out in the near future. The G20 is already engaged with One Health (OH) issues and pandemic preparedness is one of the current focus areas.India, representing the Global South, is expected to play a role in integrating equity considerations in the ongoing negotiations. Scholars have enunciated three key equity considerations. First, the appropriate use, recognition, and protection of indigenous knowledge, which has traditionally recognised the interconnectedness of human, non-human and ecosystem health. Second, the substantive and equitable inclusion of women and minority groups, including racial, ethnic and sexual minorities – traditionally under-represented groups in treaty design and implementation. Third, the use of health equity impact and gender-based analysis to identify and develop mitigation plans for the potentially inequitable impact of epidemics.On the domestic front, the tasks include promoting the establishment of OH infrastructure. This will need an integrated OH surveillance system, building and nurturing partnerships to connect and share data on infectious pathogens in wildlife, companion animals, livestock, humans, the environment, and related risk factors. India will also need to build OH capacity and pandemic preparedness monitoring and assessment into the state and district governance architecture that will draw upon an inter-/ transdisciplinary OH evaluation framework and methodology, including metrics for measuring success.The writer is chairperson, Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi and co-investigator at the UKRI-GCRF One Health Poultry Hub

India@75, Looking@100: Making a better country for children

The Indian Express | 1 week ago | 22-03-2023 | 01:45 pm

The Indian Express

1 week ago | 22-03-2023 | 01:45 pm

My father passed away on March 7, 2023. He was almost 96. Like many in his generation, he had been involved in the freedom movement. He recalled that in his speech on 15 August 1947, as the office secretary of the Sub-Divisional Congress Committee in Alipurduar, he said, “Although we have got independence no doubt, it’s only political independence. We have a long way to go. We are still not economically free. We have to now get real freedom through our own efforts.”After 75 years, it would perhaps be good to take stock of whether the dreams of independence that my father and others like him had, have been realised. Is India shining equally on all its young citizens who constitute close to 40 per cent of the population?In these 75 years, there have been plenty of laws, policies, plans, and schemes set up to protect children and their rights. The Eleventh Five Year Plan, for the first time, even had a separate chapter with child rights. Child budgeting has been adopted nationally, and in several states. Almost every child is now enrolled in school, including more girls. Many more children are immunised, there is greater reporting of violence against children, the silence and stigma around child sexual violence is breaking down, and incidences of child marriage have decreased.But some old challenges remain, while others have intensified, and new ones have emerged. Inequities persist due to social norms, caste, religion, gender identity, disabilities, region, or ethnicity. While there continues to be a rural-urban divide, many children are growing up in unplanned and poor living conditions in under-resourced habitations, with the constant threat of eviction. There is better enrolment in schools, but retention rates are not optimal. Forced migration, human smuggling and trafficking, abuse and exploitation remain realities. There is increasing violence based on religion and ethnicity. India still has one of the worst rates of child malnutrition in the world, and is home to the highest number of child labourers. There are children who remain hungry despite an increase in food production. Infant mortality rates may have reduced but access to healthcare is unaffordable in the wake of increasing privatisation of services.Children and young people are a part of the ecosystem that we as adults provide them. Unfortunately, we find that children are aggressive, intolerant, and discriminatory — all because of what they see around them.Internet-based communications and social media offer innumerable possibilities, but have also brought hitherto unknown forms of exploitation. Young people find themselves increasingly lost in the new market economy that cuts back on job security and welfare. They are also grappling with mental health issues, addictive behaviour, and substance abuse.The numerous challenges posed by the Covid-19 lockdowns have reversed many of the gains made over the years. That is why when the Union Budget 2023-24 was announced, we were not just concerned but shocked. An analysis by HAQ: Centre for Child Rights’ shows that the budget allocation for children was the lowest in the last 12 years, down from an average 5 per cent to 2.30 per cent, despite the impact of Covid. The budget allocations for key ministries too have reduced — for the Ministry of Women and Child Development, it dropped by 2.54 per cent, for the Ministry of Labour and Employment, which deals with child labour, by 33 per cent, and for the Ministry of Minority Affairs, it fell by 37.81 per cent.Divided as they are by gender, caste, religion, ethnicity, region or (dis)ability, it is critical that no child is excluded from accessing services. This needs a sound data collection and monitoring mechanism that tracks those who are left out. The government must remember that it has committed to “Leave No One Behind” (LNOB), a basic principle of the Sustainable Development Goals (SDG). This means guaranteeing inclusion and non-discrimination. More stringent laws may appease public demand for retribution, but cannot be the solution to complex social problems. That lies in investment in social change behaviour, in better access to justice and basic services. What we need is a 360 degree approach focused on creating an enabling environment that is safe and empowering.The dreams and aspirations of our children and young people are changing. We need to listen to them and encourage them to speak freely without fear. But that can only happen when we as adults value constructive criticism. We need an environment that will breed an independent-thinking, fearless generation to take forward the democracy we wish to be. These are the dreams I have for children in the 75th year of India’s independence.The writer is the Co-Founder and former director of HAQ: Centre for Child Rights. Views are personal. This article is part of an ongoing series, which began on August 15, by women who have made a mark, across sectors

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