Patricia Mukhim
For us in the media the coronavirus pandemic has been a blistering roller coaster ride. But when have we ever had a joyride anyway? Is there any other profession, (other than some investment banking – stock market wizard where you look to profit by the minute), where a person is scrutinized so scrupulously? We are accountable for every single news, every day. Do we make mistakes? Perhaps that question must be preceded by this one – “Are we humans or machines?” If we are humans then we are liable to err. That’s why we accept rejoinders that counter our facts as we had gathered them the previous day.
It is said that truth can be a prism, or a rainbow that one sees by looking through it. It depends on the angle, the time of day, and the capabilities of the people involved. Looking for that single truth is murky and frustrating; exasperating and incongruent; incorrigible and just plain exhausting. While one version of the truth can make your serene, someone can come up with a complete opposite of what you thought was his/her truth and which can send you into an apoplectic fit. With age I realise there are different versions of the truth and I am still in the process of beginning to understand that.
As a journalist of some experience one realises on interviewing people in responsible positions that they are never candid. The ambivalence is revealed by the lack of excitement answering queries. You may be speaking to a person on the phone and not see his/her face but you can’t miss the guarded nature of the conversation. When they utter one sentence they have carefully thought out how they will cover up for that sentence in case they are proven wrong. They are always second guessing about the spin the media could give to a story. This is especially true with politicians and bureaucrats. My respect or lack of it, for politicians, bureaucrats, police officials etc., is based on their track records and their honesty/dishonest quotient.
These days as we tackle Covid-19 in varied ways depending on our respective professions there are certain set routines which we are conforming to. The media too is expected to fall into this routine. So there’s a daily Covid briefing lasting approximately an hour. In that hour if a question is asked to the Deputy Chief Minister which is not run of the mill and which he is not ready to answer, he usually reverts to a wisecrack and tries to put the journalist in his/her place. It’s a subtle warning that one should just listen to the briefing from a Government that knows it all and not question, because journalists are not doctors or scientists and therefore are not expected to know what they are asking about. I find this downright patronizing because, let’s face it, no one has any proprietary knowledge claim on the behaviour of the coronavirus. We are all flummoxed by the number of times that WHO, ICMR, FDA, NIH et al have down a complete turn-around from what they said in January, then March and then June. At one time we were told N95 masks were the safest. Today we are cautioned not to wear them. The only cautionary standard operating procedures (SPOs) that have remained unchanged are (a) social distancing, (b) hand hygiene by washing or using sanitizers (c) wearing masks.
Scientists from WHO are themselves saying one thing, one day and retracting it the next day when confronted with better studies. For instance Dr Maria Van Kerkhove, who leads the emerging disease and zoonosis unit, claimed at one time that spread of coronavirus from people who are asymptomatic (never develop symptoms) is “very rare.” Very soon, a study found that infected people without symptoms were shown to be contagious in a window of time lasting anywhere from three to 12 days, with eight days being the average. So without any apparent symptoms, these virus carriers could continue shedding and spreading Covid-19 for about a week, the study said. Meanwhile, Dr. Anthony Fauci, the US’s infectious disease expert debunked Kerkhove’s statement as “not correct” and pointed out that between 25% and 45% of those infected never show symptoms. As many as 86% of the people initially infected in Wuhan, China became sick from people who were not sick enough to visit the doctor, scientists found in a paper published in Science (May 1, 2020).These could have been people with no symptoms (asymptomatic) or people who had mild enough symptoms that they caused little concern.
Then we come to treatment of Covid-19. First there was this hype about Hydroxychloroquine being the drug of choice; then we had medical scientists discounting it. Now suddenly Remdesivir injection (a broad spectrum anti-viral medication, with each injection of 100 mg vial costing Rs 4000) seems to be the medication of choice. On July 8, Drug Company Cipla said it would launch the injection in India which would be available through government and hospital channels only. Remdesivir is the only drug approved by the United States Food and Drug Administration (USFDA) for Emergency Use Authorisation (EUA) treatment of adult and paediatric patients hospitalised with suspected or laboratory confirmed COVID-19 infection.
The Drug Controller General of India has in turn approved two anti-viral drugs for treatment of Covid-19 – Remdesivir for Covid-19 patients on oxygen support and Favipiravir for those with mild to moderate symptoms. Favipiravir was launched recently by Glenmark Pharmaceuticals, while Cipla and Hetero introduced Remdesivir. Many experts, however, have raised concerns on their efficacy stating that both these drugs were originally designed to treat other diseases such as skin disease or arthritis.
Added to this confusion is the efficacy of the Covid-19 tests following the conflicting results of a doctor from Nazareth Hospital who was first tested there with the GeneXpert method and was found negative. Pasteur with its RT-PCR test also found the doctor Covid-negative. But NEIGRIHMS with the same test method found his samples positive. More confusion, more discussions. After all, these days Covid is the only topic of discussion
I asked a senior doctor about false negatives and false positives vis-à-vis Covid tests. He said sensitivity and specificity of RT-PCR is about 70% and factors that influence the results are
1) Timing of collection of sample 2) Proper technique of collection of sample 3) Type of sample-invasive samples like bronchoalveolar lavage (BAL), also known as bronchoalveolar washing (a diagnostic method of the lower respiratory system in which a bronchoscope is passed through the mouth or nose into an appropriate airway in the lungs, with a measured amount of fluid introduced and then collected for examination), and sputum have better yield than throat and naso-pharyngeal swabs 4) Tests will yield better results before starting anti-virals. Sample should be collected between 5 to 10 days of exposure. 6) A lower viral load may not be detected in RT-PCR. 7) Cold chain should be maintained 8) If processing is delayed beyond 24 hours, sample should be refrigerated. 9) Beyond 7 days sample has to be stored at – 80 degrees Centigrade.
After all this, confusion is confounded and we know that the whole world is proceeding on a trial and error method as far as tackling Covid is concerned. Hence mistakes are inevitable. Should doctors, nurses, governments, communities, individuals then be blamed if anything goes wrong? Should people spread conspiracy theories that government is hiding real statistics of Covid patients? If we do so we will only hurt ourselves.
Government could go wrong in their methods and there’s no harm in admitting that. Some lack of coordination between the administration and community institutions is possible. What’s needed is the spirit of cooperation and not of proving who is right and who is wrong. After all, we are all humans. What is upsetting people is that some privileged citizens manage to get past all the strict travel regulations imposed on ordinary mortals. This patronage has to stop!
At this point let’s try and be human. None of us is without fault, more so us in the media although we try our best and have now learnt more scientific terminology in seven months than we have done in all our adult lives.
Once again I reiterate that our brief is to give voice to the weak, the disempowered and the destitute, above all.