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Death toll rises to 75 in India with 2,904 cases, ICMR gives nod for rapid, antibody-based testing

About 42% of those confirmed positive for COVID-19 in India are between the ages of 21-40 years old, the Union Health Ministry said on Saturday, for the first time throwing light on the demography of the disease in India. Only 17% of those testing positive were over 60.

By comparison, data from the U.S. Centres for Disease Control said 29% of those affected were in the 20-44 age group and 32% were above 60. India recorded 2,904 cases and 75 deaths as on Saturday compared to the 2,79,355 cases and 7,451 deaths in the United States.

However, Joint Secretary in the Health Ministry Lav Agarwal, who shared the data with the media, did not provide any age-specific analysis on mortality in the country, only saying that most of those who succumbed to the disease were “aged” and also had underlying complications such as the diabetes and cardiovascular disease.

Mr. Agarwal added that 9% of those testing positive were below 20 years.

The Ministry said the number of new cases recorded nationwide between Friday and Saturday was 601, with 58 critically ill in Kerala, Madhya Pradesh and Delhi.

The death toll from the outbreak, according to data from State Health Departments, rose to 103 with Maharashtra reporting the maximum at 32. The most number of active cases were also reported from Maharashtra at 551, followed by Tamil Nadu with 476 and Delhi with 431 of the total 3,196 cases.

Quick results

As the number of cases continued to rise, the Indian Council of Medical Research (ICMR) issued an advisory to start rapid antibody based blood tests in areas reporting clusters and in large migration gatherings or evacuee centres. The results of such tests will be available in 15-30 minutes.

The Health Ministry said nearly 30% of the cases were linked to last month’s Tablighi Jamaat meet in Delhi.

Nearly 100 scientists worldwide collaborated for it

The novel coronavirus

In a breathtaking feat, nearly 100 scientists from across the globe worked together to study the genes of the novel coronavirus (SARS-CoV-2) and have published a list of drugs that can be repurposed to treat COVID-19.

The study posted on preprint server bioRxiv on March 27 is yet to be peer-reviewed or published in a scientific journal.

The proteins of the virus must attach to the human proteins to cause the infection. The team studied 26 coronavirus genes that help in the production of these proteins. It also studied human proteins and found 332 SARS-CoV-2 and human protein interactions. The team then listed 67 human proteins that can be targeted by 69 drugs to fight the infection. These drugs include the those under clinical trials and/or preclinical compounds.

“When the virus invades the cells, it hijacks the cells’ molecular machinery to replicate itself because it cannot do this on its own. The drugs we have identified may be able to inhibit these molecular machines so that the virus can no longer use them for its own survival. However, they still need to be further tested,” said Mehdi Bouhaddou, one of the authors. He is a post-doctoral fellow at the University of California, San Francisco.

Familiar names

The list includes unexpected candidates such as entacapone used to treat Parkinson’s disease. Another is the antiviral medication named ribavirin, which was administered to Nipah patients in Kerala during the 2018 outbreak. Chloroquine, an antimalarial drug, and metformin, used to treat diabetes, are also there.

“The next step is to test these drugs in labs we are collaborating with in New York (Mount Sinai) and Paris (Pasteur Institute), where they have the virus growing,” he said.

It also released guidelines on the use of rapid antibody testing kits

The Indian Council for Medical Research (ICMR) made public guidelines that detail how the country plans to manage a “large outbreak” as well as guidelines on how rapid antibody test kits ought to deployed. India’s official position is that there is no evidence of community transmission in the country.

According to Lav Agrawal, spokesperson, Health Ministry, 30% (about 1,000 positive cases spread across 17 States) of India’s total case count is attributable to the Tablighi Jamaat gathering in Delhi earlier this month.

The plan for large outbreaks, released on Saturday, specifies: active surveillance for cases and contacts in the identified geographic zone, expanding laboratory capacity for testing all suspect cases, high risk contacts and Sever Acute Respiratory Illness cases, operationalise surge capacities created for isolation (COVID-19 hospitals/COVID-19 dedicated blocks) to hospitalise and manage all suspect/confirmed cases, implementing physical distancing measures with strict perimeter control, provide chemoprophylaxis with hydroxy-chloroquine to all asymptomatic healthcare workers and asymptomatic household contacts of laboratory confirmed cases.

It also detailed guidelines on the use of rapid antibody testing kits. Unlike the real-time RT-PCR kits that are used to detect an ongoing infection, these kits — within 15 minutes to two hours at the maximum — can say if a person has ever been infected by the virus and gives authorities an estimate of whether there are asymptomatic carriers of the infection in a community.

Knowing the proportion of asymptomatic carriers to positive cases gives an insight into the infectivity of the disease, transmission patterns and helps prepare for the long-term management of the epidemic. Testing negative via an antibody kit doesn’t automatically rule out infection and needs to be supplemented by a PCR test, the ICMR guidelines specify.

Hundreds of antibody kit manufacturers have been approved in India in the last week to offer tests, according to the Health Ministry website.

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