What is the threat from global COVID-19 rise? (GS Paper 3, Science and Tech)
Why in news?
- The Union Ministry of Health has issued a communique to States to resume genome sequencing of new cases of COVID-19, in view of the sudden spurt of cases in some parts of the world.
- The sequencing of positive case samples will allow the Indian SARS-CoV-2 Genomics Consortium network to track the variants, enabling timely detection of newer variants, in order to undertake requisite public health measures in time.
- States were asked to daily send samples of all positive cases to INSACOG labs.
What was the situation in India in 2022?
- After ravaging the world for nearly two years, COVID-19 gave India a respite from the mid first quarter of 2022.
- While a total of 4.47 crore cases of COVID-19 were detected cumulatively in India, and the number of deaths stood at 5.31 lakh, the number of cases began going down from March 2022, with only 201 new cases reported on December 23.
- Consequently, restrictions that were imposed on public movement in the country were eased out.
- With the Indian government removing the Air Suvidha notification for international travel, end November, the last vestige of the pandemic protocol, was shed.
What is the global situation?
- In the U.S., a trifecta of viruses; Respiratory Syncytial Virus, Influenza and COVID-19, led to a rising number of respiratory infection cases since September, accelerating post November.
- In China, the number of cases began to soar as it dropped its zero-COVID policy and lifted all restrictions, in response to unprecedented protests. Because of the sheer size of the population and the fact that the nation had not been exposed properly to the natural march of the virus, there has been a massive surge end of the year.
- It has reached a stage where the doubling time was just a few hours.
- Simultaneously in Brazil, Korea and Japan, rising numbers have been a source of concern.
What happened in China?
- With its polar approaches, China made mistakes in handling the epidemic.
- Every pandemic will ‘equilibrate’, and over a period of time, level out infection levels across the world. It is not possible for some areas in the world to have a large number of cases, and others stop with low numbers.
- China also has low hybrid immunity, which is immunity granted by the twin factors of natural infection and vaccination, since it artificially suppressed the waves of COVID-19 with harsh restrictions.
- China will have about 80 crore infections in a matter of three months, i.e. 60% of its population will be impacted.
What are the future implications for India?
- The situation in India is under control, but vigil is necessary. The bulk of the adult population has been vaccinated with effective vaccines. About 70% of the country has been fully vaccinated, though booster vaccination is flagging.
- Almost all the sub-variants of Omicron found across the world were circulating in India as well, and no alarming situation has emerged so far.
- The government has just sanctioned the use of nasal vaccine for the 18-plus group as a booster. In a scenario where the number of tests has dropped (the total number of daily tests in India is at 1,15,734, against high prevalence States conducting a lakh or more tests daily during the peaks), he recommends conducting waste water surveillance for monitoring community infections.
Diabetes remission through intermittent calorie-restricted diet
(GS Paper 3, Science and Tech)
Context:
- While many studies have validated the effectiveness and benefits of intermittent fasting in people with type-2 diabetes, no clinical trials have so far investigated the effectiveness of intermittent fasting in achieving remission.
- A small randomised, control trial with intermittent calorie-restricted diet carried out in people with type-2 diabetes was able to achieve remission in nearly 50% of the participants in the intervention group at the end of three months of follow-up after the trial.
Details:
- The trial lasted for three months. Even at 12 months of follow-up, remission was seen in 44% of the participants. All participants who achieved remission had completely stopped taking any drug to control blood sugar, and the remission lasted at least one year.
- Even with the more stringent criteria for complete remission, which describes a return to normal measures of glucose metabolism (HbA1c in the normal range, and fasting blood glucose of 100 mg/dL) of at least one year duration in the absence of any anti-diabetic drugs, 33.3% (12/36) of participants in the intervention group achieved complete remission.
- For the trial, remission was defined as stable HbA1c levels less than 6.5% (48 mmol/mol) after discontinuing anti-diabetic medications for at least three months. During the trial, dosage of anti-diabetic medications was adjusted depending on blood glucose levels.
Yardsticks in the trail:
- Participants in the intervention arm received the Chinese Medical Nutrition Therapy (CMNT) diet and underwent intermittent fasting for five days, followed by 10 days of ad libitum eating of everyday food items.
- The participants went through six cycles of intermittent fasting, followed by ad libitum eating during the three months of trial. The CMNT diet contains daily foods such as wheat, barley, rice, rye, and oat, and features low glycaemic loads, calories, and carbohydrates.
- The authors found that participants who were prescribed fewer anti-diabetics drugs were more likely to achieve diabetes remission than those taking more drugs to control blood sugar. However, duration of type-2 diabetes did not influence diabetes remission in participants.
- The potential mechanism of the CMNT in achieving remission is by improving islet cell function, intestinal flora and liver glucose metabolism show. This allows the participants to revert to normal diet after three-month trial period
Way Forward:
- All participants have been followed up for two years by now, and a follow-up of five years or more is ongoing to explore the stability of the CMNT diet and its impact on complications.
- The scientists are planning further research and trial involving more participants living in a larger geographical area and a CMNT digital medical product for diabetes that combines biotechnology with information technology is under way.
