THE MUTANT COVID-19, CYTOKINE STORM & BREACHING OF BIO BUBBLE

 

THE MUTANT COVID-19, CYTOKINE STORM & BREACHING OF BIO BUBBLE

                                        Anil K Khaware

                                        ADVOCATE

We are still in Covid-19 phase and the life is virtually standstill in a manner which was, probably, never imagined. The nemesis caused by COVID-19 is there for everyone to see. The Covid-19 had already taken a huge toll, the mutant virus is further unleashing virulence of high proportion. The preemptive and therapeutic measure has still been in vogue, though, but not with very tangible result so far . In this backdrop, surfacing of a new variant discovered in Kurnool (Andhra Pradesh) raised a scientific enigma. It is named as N440K. This is found to be a factor which is causing vastly increased virulence. The nationwide syndrome in the last fortnight is attributed to mutant virus, including the novel mutant virus  N440K. The 440 number itself indicates danger and as firstly it was discovered in Kurnool ( Andhra Pradesh), therefore, it is also known as AP Virus. The mutant virus N440K has taken in its ambit various states, more particularly,  the state of Andhra Pradesh,  Telegana, Karnataka,  Maharashtra & Chhatisgarh. The Centre of Cellular & Molecular Biology (CCMB), Hyderabad is stated to have found the strain substantively more infectious. It causes illness in 3-4 days. The new strain is found more virulent than hitherto known mutant such as B.1, B.1.617, and B.1.618. It is noticed that N440K has low incubation period and thus it develops early to cause damage. Another aspect which is worth noticing is that its virulence potential is more when it mingles with other variants. Thus, the penchant of virus is of social cohesion to make it potentially more dangerous. The scientists are reportedly still amused of its great speed. Though, in Southern part of India the existing variants are as under:

1.  B.1,  

2.   B. 1.1.7 

3.   B.1.351  

4.   B.1617 

 

Now, the variant also includes  B.1.36 (N 440K)

The presence of other new variants of corona virus -E484Q is also reported in Maharashtra, Kerala and Telangana. It appears that all variants named above compete with themselves as regards which variant can cause more virulence and survive more. 

COVID AND Bio bubble

We know that in the midst of Covid Pandemic 14^th edition of Indian Premium League (IPL) a T-20 cricket competition was organized. In view of prevailing pandemic, though, it was organized in Six (6) Cities only. The Covid-19, however, adept that it is in changing its character had unleashed the catastrophe and now, while, this line is being written, the IPL stands cancelled, in view of various players and members of team management of several franchisee was reportedly infected with Covid, rendering the ongoing tournament as improbable, hence, the decision. The much hyped discussion of Bio Bubble that came to the fore needs scrutiny. All the while as it was claimed that because of Bio Bubble, the cricket tournament could be successfully organized and COVID shall remain in bay, because of the novelty in organizing and the concept of Bio bubble. However, the Covid as a novel character has acted like Horse of Chess and all the stakeholders in the chessboard remained amused. It may, thus, be worthwhile to analyze the term-Bio Bubble & its effectiveness. 

A bio-secure bubble typically consists of multiple sites comprising a secure perimeter (within close proximity to each other), including player residences (such as hotels), training facilities, and the venue proper. All participants, whether players or team staff, and other ancillary staff present on-site were to be screened and tested for COVID-19 before entering the bubble. They were not permitted to leave the perimeter until the end of the play. The participants were regularly screened and tested for COVID-19, and there were complete restriction and no access was afforded to general public. The provision of penalty or reprimand was prescribed if there was to be any aberration to the bio security protocols, while they were within the bubble

Thus, Bio bubble was created in such a manner so that it was perceived as a “safe and secure environment” used to host sporting events during the COVID-19 pandemic. It was felt that the bio bubble could only be accessed by a certain set of people. However, 14^th IPL was suspended due to covid infection of Four (4) players and also its support staff. The Covid has thus penetrated the Bio Bubble- but how?

Strangely, whereas a bio-bubble was perceived as invisible shield to insulate hosting of sporting events and it was claimed that bio bubble is a safe and secure environment as that could only be accessed by a certain set of people who have tested negative for COVID-19 so as to minimise the risk of transmission of the Covid from one person to another during the course of the event. Of late, the Bio Bubble was successfully invoked in the sporting events such as India's tour of Australia, previous edition of IPL, US Open and so on. In IPL 14 Cricket tournament, however, Covid -19 has hoaxed the bio bubble and the tournament was cancelled.

The bio-secure environment can be well defined. In the case of sporting event such as IPL, parts of a hotel or stadium and the players were allowed to access only those parts to prevent any physical interaction with the outside world. For instance, it is a matter of record that during the US Open tennis Event , the players were allowed to travel from the hotel to the stadium and vice-versa and nowhere.

The pre-requisite of entering a bio-bubble is to clear the RT-PCR test before player leaves his home country and once a player arrives at the playing destination, the player is subjected to another test for COVID-19 and has to confine in a room until the results are declared. 

To be abundantly cautious, during the previous edition of IPL each player was required to wear a Bluetooth band at all times. If a player was to come to the close proximity to other person, the band would beep. In the US Open, a novel accreditation card was issued with RFID code for contact tracing, should someone tests positive for COVID-19.

 

In July 2020, the West Indies tour of England was the first International cricket tournament that was played as per bio-bubble norms. It was successfully organized. The norms were stringent, in as much as if someone left the bio-bubble during the tournament, then isolation period of Five (5) days was a must and he was also required to pass two COVID-19 tests, before returning to the bio-secure environment. As regards the breach of norms, the first instance was when the bio-bubble breach was highlighted when Jofra Archer of England was dropped from the second Test due to the breach of bio-security protocols. 

The  IPL 14 was scheduled to be played between 9 April to 30 May 2021 across six different venues in India i.e - Ahmedabad, Bengaluru, Chennai, Delhi, Kolkata & Mumbai.  The teams were to play only at neutral venues and the concept of home advantage was no more existed. Moreover, the tournament was planned in such a manner so that each team were to play at four venues only and they were to  travel only thrice in the course of tournament. Each venue across the country had its own bio-secure environment and the players had to undergo a Seven (7) day quarantine period to join the bio-secure bubbles. However, no sooner the formulations were in place, and just 2-3 days before the start of the tournament, it was reported that more than dozens of in IPL Broadcast bio-bubble had tested positive for COVID-19.

The IPL 14 were generally to be held without public spectators. Moreover, events within a bubble were organized in such a way so as to accord feeling to the Television Audience of real time noises and broadcasters could employ such production techniques to connect with the audience adequately The venues were also to be customized with video boards and artificial crowd noise to replicate the experience of the venue  and virtual fans mosaic was also created. The planning, the commerce and paraphernalia however could not match the capacity of Covid-19 and it acted truant in its penetration.

Cytokine Storm: Is it fuelling COVID-19?

When we were still to come to terms with Covid-19 and its mutant, but as if in a typical nonchalance, it is found that some of the infected patients develop severe COVID-19 and the same is probably due to overreaction of their immune systems. The triggering of such overreaction is called a cytokine storm The composition of cytokines also may be analyzed. This is a protein released from the immune system in reaction to infection, however, as it is construed as overreaction, thus, rather than helping the defence system in real sense of term, it kills good cell also resultantly, this may lead to multiple organ failure.

The scientist believe that whereas COVID-19 infection only results in mild to moderate infection, however, it turns out  fatal, probably due to overreaction of immune system against the infection and in that zeal starts killing good cells and tissues, whereas virus  remains unaffected and the virulence of the mutant covid-19 is attributed due to the potential of mutant virus in eliciting overreacti9on from the body. In cytokine storm high quantity of cytokine protein are released in body quickly and being oblivious to the need of killing the replicated virus in a hot pursuit kills the good cells without identifying and targeting the virus. This leads to death.

The expert feels that cytokine storm leads to acute respiratory distress syndrome (ARDS) and that is the real cause of death in COVID-19 disease. The covid patients are also reported  with high blood levels of cytokines  and that is detected because of the cytokine storm. The cytokine storm, as is illustrated above, is an uncontrolled systemic inflammatory response which is caused due to release of cytokine from immune cells in case of Covid infected patients.. The initial point or location of cytokine storm is believed to be Lungs and once the lungs are infected substantively, the overreaction is elicited and other vital organs are attacked leading to multiple organ failure. The consequence of the attack is that oxygen starts depleting in the body causing the immune system becoming redundant.

 

 

 

 

The word “storm” itself indicate hyper activity and thus “cytokine storms” are called storms as firstly, they are uncertain and unpredictable and secondly they are uncontrollable. The researcher are broadly of the view that it is not possible to control cytokine storm and  it can only be modulated to an extent only with the aid of some immune modulation medicines. The potential inhibitor drugs to cytokine storm is being developed, though that is only in clinical trial. It is however believed that cytokine storm is not confined to COVID-19 only, but other sever infection may also lead to that. For instance, the bird flu caused by H5N1 influenza virus..

REMARK

India has the will and resolve to negate the pandemic. The Human Resources, young populace, more particularly, young professionals such as Doctors, Paramedics and Nurses as a frontline barrier to Covid-19 shall certainly have the wherewithal to wipe out the danger altogether. The country is in a trying time, sure, but no time is permanent nor any effort is final until one stops trying. Though, a vast section of political stream, unwittingly is failing India by avoidable statements. Governing a vast country like India is not easy and temptation to criticism should be avoided when unity for a purpose is the need of the hour. No doubt, playing politics may remain in agenda of political parties and they should be entitled to do that, but certainly not in a National hour of crisis. The populace should be vastly informed , but panic should not be allowed to be set in. Raising the issue of alleged failure of the Governments, whether that of centre or respective states at this point of time, shall be akin to place cart before horse. The time shall be available for postmortem of the issue, then why raise an issue of alleged mismanagement at this point of time? It is time of contribution not retribution.  

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