Mapping The Minefields – 1

Recently, China started expanding into Cape Verde, an island deep in the Atlantic ocean, far away from its borders. To make it simple, closer in the range to strike the US. China is continuously in dispute with all its neighbors. Be it Russia, Mongolia, Vietnam, Nepal, India, Cambodia, Myanmar. Wherever, it land or maritime borders reach, China has a claim. Modus tollen is simple – find a reason – geographic, historical, or whatever, it should become Chinese land. Thus, China’s claim over land within Nepal dates back to 1962, Vladivostok to 1860, Tibet to 1788, etc. I will publish a series of articles on these land encroachment, disputes, and the resolution. https://mymilieu.org/2021/02/26/mapping-the-minefields-1/

(This interesting piece of Chinese nationhood is inexorably less understood. It is interesting to know how China is indulging in land grabbing with every other nation with which it shares the border. I will cover this topic in multiple parts. I will upload cartographic pictures on my blog site).

Competition is always encouraging, especially when it happens to dismantle a 75-year-old hegemony over global affairs. However, anyone will abhor and detest a winner from the competition to be dictatorial, repressive, and regressive.

Are we biased?
Let us hypothesize that we are biased before giving the benefit of the doubt that we are not. Let us analyze our internal bias before we proceed and presume we are not anti-China. It is possible; we have been capsized by Stockholm Syndrome (please read my earlier blog). Several indicators support Chinese Machiavelli. These range from territorial aggrandizement, guzzling raw resources (such as rare earth, premium metals, and upstream river water), South China Sea encroachments, illegal occupation of Tibet, Xinjiang, and Hong Kong, persistent threat to the autonomy of Taiwan, technology (IP) theft, currency manipulation, deftly planned obsolescence, economic exploitation of vulnerable nation and repression of internal human rights. Am I still biased? Well, I have reasons to support that I am not. Yes, I would have been guilty of a bias had I mentioned Ladhak, Dokhlam, encouraging Pakistan terrorism, North East Insurgency, or Kashmir. However, I removed these confounding factors. Suffice it to say, at least I am not biased.

A revival of Great Sly Silk Road
Well, every segment of the border is defined by a different historical year. Nine dash, or Tibet or India, Kazakistan or Vladivostok

The Great Wall of Sand
Nine-Dash, sometimes also called Ten-Dash or Eleven-Dash, depending upon how long and deep you want to extend the conflagration. If you want to claim Spratley, Paracel, and the Pratas Islands, you can debate any approach to settle the scores. Finally, the brute (and now V-Brute) force will determine the Straits of Taiwan’s outcome. Remember, the benchmark year for China’s claim over the South China Seas is 1947/1949.

Tibet – A repression that knows no bounds
Before the 1949/50 Chinese invasion, Tibet was an independent nation, with consulates in Lhasa. Tibet had its national flag, currency, stamps, passports, and a small army. Sensing the Tibetan army’s weakness, China intentionally transferred Hun Chinese into Tibet around 1949/50. For almost ten years, Tibet fought for autonomy, and finally, China occupied Tibet in 1959/60, driving out The Dalai Lama and his monks and destroying their monasteries. According to the People’s Republic of China, Tibet was ruled by the Qing dynasty in the 16th and 17th centuries. However, after that, it was Nepal that ruled Tibet from 1788. Irrespective, the gerrymandering of Tibet by mass transplanting Hun Chinese amounts to a serious violation of the Fourth Geneva Convention of 1949. The Dalai Lama claims that China has killed almost 1.2 million Tibetans since its occupation. The Chinese claim that they have built infrastructure and increased the GDP in Tibet to 30 times. My question to you – Will any amongst you like Chinese infrastructure and GDP at the cost of your freedom? Remember, the benchmark year for the claim of China over Tibet is 1788.

Vladivostok, the Eastern part of Russia, adjacent to China’s eastern part, is claimed by China. Why not? The logic is simple: if you pull an imaginary line on China’s northern border, Vladivostok falls within the Chinese territory. All China has to do is being ingenious to support its claim. History indicates that until 1860, Vladivostok was part of China. However, after the second opium war, Primorsky Krai (an equivalent of a state) and its capital were administered by Russia. Thus, it is just the acceptance of modus-tollen that underpins China’s claim over Vladivostok. Remember, the benchmark year for China’s claim over the Vladivostok is 1860.

Nepal – Rui Gaon, Tegha and Annapurna, now part of China
Up until 1962, the residents of Rui Gaon (translated village) were part of Nepal. The residents there paid revenue (tax) to the district in Nepal. Thereafter, China simply moved the pillars and claimed them to be part of Tibet. Now, Rui Gaon (village) is part of China. The picture mentioned below has all the flashpoints between Nepal and China. Just imagine a reticent Nepal as a belligerent state and provoking a monk (China). One can safely guess that the blue lines will eventually become the future flashpoints between China and Nepal. Remember, the benchmark year for China’s claim over the Rui Gaon, Tegha, and Annapurna is 1962.

The vision of a great nation rests on territorial expansion. The road to connect this resurgent middle kingdom is the Silk Road, also known as the Belt and Road Initiative; the land route connects to the consumer base in Europe. There is always a surplus and scrap; what do we do? Never through the scrap, sell it to Africa. If they don’t have the money to pay, well sell now (on loan) and book the profits later. Truly not an ingenious model but definitely a sly model.

Trumpism in hindsight
I was always mesmerized by the raucous noise by Trump against China. That was the best we aligned. Never realizing that too was shallow and superfluous. While Trump indulged in sensational knee-jerk diplomacy, the state department continuously monitored the Chinese global growth points, irrespective of Hambantota (Sri Lanka), Gwadar (Pakistan), Djibouti, or Cape Verde. It was willful and criminal negligence towards these Chinese Growth Points. Why? When you nominate people with thin resumes or those from your donors, you sacrifice the higher intent of protecting the land. It is willful, and yes, it is criminal because the country, in general, has to face the aftermath of their inadequate decisions.

Cape Verde – An infrastructure Diplomacy
I never knew there is an island country called Vape Verde, almost in the middle of the Atlantic. China helped build a football stadium, a presidential palace, and another $60 million worth of infrastructure investment. So the US has awakened (though under a different administration) to another growth point on the west of Africa.

Gradually and steadily, China is building a minefield for a future confrontation. If we forget history, we are doomed to repeat the mistakes of the past. Material success is not a measure of wisdom, and China seems to have that insight.

Great power competition: the US boosts Africa diplomacy on land and sea
https://asia.nikkei.com/Politics/International-relations/Great-power-competition-US-boosts-Africa-diplomacy-on-land-and-sea

https://www.bbc.com/news/world-asia-pacific-16689779

https://www.culturalsurvival.org/publications/cultural-survival-quarterly/legal-status-tibet

https://freetibet.org/about/china-argument

Watch ‘Vox Borders’, https://www.imdb.com/title/tt9563892/

Manage COVID After A Recess

While the US, EU, UK, Brazil and South Africa were smoldering with the newer variants of COVID, many in India thought COVID was done and dusted. Life was back to normalcy, hardly realizing that India was in the same stage of ignorance as it was exactly an year ago. COVID is back, and this time it will be with a vengeance. What do we do now? I have discussed the relevant principles so that you can make changes to your lifestyle in accordance with the emerging threat from the newer variants.

A few weeks back, when I talked with several Commissioners and Administrative officers from Maharashtra, Tamil Nadu, and at the Center (Delhi), the palpable feeling was that Covid is “done and dusted”. Life was back to normalcy, and all cautions were out of the window.

A few weeks back, when I talked with several Commissioners and Administrative officers from Maharashtra, Tamil Nadu, and at the Center (Delhi), the palpable feeling was that Covid is “done and dusted”. Life was back to normalcy, and all cautions were out of the window.

I cautioned that it is not yet out, and I shared a blog called a tale of two worlds (link shared below) along with a few reports on the raging pandemic in the US, EU, UK, Brazil, and South America. The ignorance was high, and most felt that they had achieved herd immunity. ICMR reports indicated 24-26% national seroprevalence; Chennai’s reports indicated 40% seroprevalence, which again meant inadequate herd immunity. However, facts are generally relegated, and sentiments take precedence. Once again, I wrote another blog on Herd Immunity (link cited below). Always remember TWO MOST principles of herd immunity –

  1. The entire population should be 60-80%
  2. The epitope (in this case, the viral protein) should be constant, not changing

It is in the nature of this virus that the structure is changing every few weeks. Another blog that was written a long time back on this nature of virus was shared with the medical community. To summarize, the covid virus has a defect with RDRP, an enzyme that helps in multiplication. It creates typos, like the one we unintentionally do while typing. However, with covid, those typos change the structure (changes to S or Spike protein is an example) that renders the immunity from previous infection less effective.

Thus previous infections or vaccines are likely not to provide the anticipated immunity. Besides, this virus’s immunity lasts for 3-6 months, as against the smallpox vaccine, which lasts life long.

So, what do we do next?

  1. Should we stop all our social activities?
  2. Should we stop interacting with our professional friends, coworkers, staff, and others?
  3. Should we quarantine and put ourselves in lockdown?

None of these are practical and pragmatic. Before I tell you what is appropriate, let me share what is inappropriate. Yesterday, I talked with a prominent businessman from Nagpur. He said he uses the alcohol-based hand cleaning solution, cloth-based face masks, and takes a shower after returning home, and puts the laundry clothes.

All except face masks are not required. This is an airborne virus, not a virus spreading through fomites (bugs on your clothes or body via touch).

What is airborne and aerosol? When an infected person sneezes, he/she blows almost over 50 million copies of the virus in one bout of coughing/sneezing. These are invisible and disperse in the air around you. An aerosol is similar to airborne, except that you can see those droplets.

Either way, noninfected people end up inhaling those viruses and ultimately increase their risk of getting infected. There are several factors involved between the sneeze/cough bout and infection by normal people. Closed space versus open space influences the outcome. Similarly, centralized air conditioning circulates the virus via the duct system, thus exposing people in other contiguous areas.

Using n95 or similar masks is THUS CRITICAL. I generally add another layer of the surgical mask when i presume exposures are likely to increase.

Social distancing helps, but it is not a panacea. Just imagine, I am not on the same floor as the infected person but connected via centralized air ducts. Will it help? No. I am logically in the same environment though I am in a different place physically. That also means you have to focus on the principles and not just the practices. Understand the principles and act accordingly.

Lockdown or Quarantine?
The most considerable toll this pandemic has taken is from lockdown. Even during the first lockdown implemented in March/April 2020, I was firmly against global lockdown. The answer is never global lockdown; it is always micro lockdown.

What is Micro Lockdown?
Only lockdown that part of the city or segment where the incidence is likely to be high. However, even micro lockdowns are easier said than done. It is difficult to identify a community of infected (but asymptomatic) people and quarantine them against a traveler arriving outside (by flight, vehicle, or train). Remember, once lockdowns are implemented, they ideally last 3-5 weeks, unlikely to be gone in one week. However, it is best to contain and segregated those suspicious of carrying the virus, be it communities, individuals, or activities.

Curtail all Social Activities
Certain activities are unavoidable, critical business, social activities (marriages, deaths, illnesses, and adverse events). However, remodeling our way of interaction is always possible. Certain principles are absolute and non-compromising (wearing a good quality mask); yet, remodeling can be done for the day’s activity, the place, the interaction, etc.

Let us understand those and tailor our activities.

Dr. Shashank Heda, MD
Founder and Chief Executive
CovidRXExchange
(A US global non-profit initiative for disseminating medical expertise and insight; working for Covid since March 2020)

Links to the blogs below –

If only we proactively spread the message within our network, engage in an active dialog, resolve the misgivings around the vaccine, start Fastrack the process to curtail the virus. Our ability to bounce back, as a nation and as a community, depends upon how we counter the virus. https://mymilieu.org/2021/02/01/evangelizing-vaccination/

The variants with the infectivity, implications on testing, therapy, and vaccines. https://mymilieu.org/2020/12/26/emergent-variants-and-infectivity/

That provides a simple explanation of how vaccination will halt the spread of the virus. https://mymilieu.org/2021/01/28/a-triple-whammy-variant-vaccination-and-complacency/,

It is an ultimate hope that the vaccine provides herd immunity or the virus comes to a state of symbiosis with humanity. Luck is never the best strategy, but it had to happen. We wish to stumble across a variant that is as good as Common Cold, leaves minimal health impacts, and possibly with minimal mutations to stabilize. In the search for this haplotype, I shared this perspective https://mymilieu.org/2021/01/10/in-search-of-a-haplotype/

https://mymilieu.org/2021/02/06/covid-a-tale-of-two-worlds/

https://mymilieu.org/2021/01/28/a-triple-whammy-variant-vaccination-and-complacency/

https://mymilieu.org/2021/02/01/evangelizing-vaccination/

White Valentine

I wished someone a White Valentine, and they said, what is that? I said it comes every 24 years, and a couple gets to see it 2-3 times in their lifetime.

What is White Valentine?
When you hold your spouse’s/partner’s hand and look outside the window, you feel Valentine, and you see a white blanket of snow that makes it white Valentine! Enjoy your white Valentine. 🎂🎉🎁🎈💐

Well, jokes apart, I haven’t seen such a precipitous drop in temperature in over two decades. Fortunately, it is still cold, and the snow hasn’t yet got converted into ice. In Texas (like in London, yes London, you heard it right) don’t have snow plowers. So the snow melts and forms a layer of ice.

The Arctic Blast
While most Dutchmen are skating over the rivers, ponds and lakes, we in Texas still have water in a fluid state. So, the only place for us to skate or walk is on the roads. No, Dallas, Houston, Austin, or San Antonio are not desert areas, as claimed by this BBC report, and we do see scorching heat, sometimes reaching 110 plus F, that lasts a few weeks. However, temperatures as low as this are very, very uncommon.

Shivering to death
No, we are not. Our internal thermostats are adjusted between 68-72 F, and we hardly realize it. Besides, an evening next to the gas-fired fireplace provides an enchanting time with family.

Flora and fauna
Yes, they definitely have. Even the deciduous trees have dropped their leaves. That saves them from extreme temperatures and transmission loss. I saw some unusual birds in the cedar trees; I believe the birds were clamoring for a warm place. I felt hapless and helpless that I could not shelter them in. My Elephant Ear plant was completely devastated despite covering it with appropriate warmth. In hindsight, I feel I should have trimmed those gorgeous leaves from the ground, but at 2′ wide, they looked so alluring, and I resisted the temptation of trimming. Yes, they are freezing, and I may lose a few more, like the Texas Blue Bonnet’s recently emerging seedlings. Fortunately, I have some seeds available that I can reseed but not sure if the blast will recur and when.

Yes, I will be having lovely Indian tea with cardamom and ginger, and I wish you too should sip and enjoy this rare White Valentine with your Valentine!

Shashank Heda
Dallas, Texas

Note: I chronicled this blog, especially for those who are outside Texas. Below excerpts from BBC

Texas is known for its sprawling deserts and excruciating heatwaves – but right now, it’s blanketed in a thick layer of ice.
The state is seeing some of its coldest temperatures in more than 30 years, with some areas breaking records that are more than a century old.

Parts of Texas hit 0F (-18C) on Sunday, and weather warnings are going to stay in place through the week. So why is this normally boiling state suddenly freezing over?

US cold snap: Why is Texas seeing Arctic temperatures?
https://www.bbc.co.uk/news/world-us-canada-56058372

Why I Ignored Farmer’s Protest

Farmer’s ongoing protests in the North have caught the attention, not just nationally but globally. Rheanna or Rita has not catapulted it to global attention. If you see this news from Nikkei Asia, the protest has been reported since September 2020. Just imagine, Corona had hardly receded, but these farmers, notwithstanding the implications of Covid, started aggregating and protesting.

Are farmers’ demands rational?
Irrespective of their demands being rational or not, the agricultural sector needs renovation and infrastructure investment. In 2019, I wrote an article on using strategies and execution to rejig the entire supply chain towards increasing the shelf life (of the produce), exactly the same way as the shelf life of grains. In a nutshell, the recommended changes were increasing rainwater conservation to increase the depleting table of water, adding several smaller catchments in areas with high rainfall or runoffs, strategies for spreading crops across varieties, harvesting and storage facilities, and consumer education on consumption. I am not sure if these changes across the value chain are reflected in the bill in some of the other forms. Farming is the foundation of the food chain, and supporting farming is important to nations’ critical infrastructure and resilience. My forefathers, like most of ours, owned small farming land (by American standard). Until her death, my grandmother lived in our village. Then why did i ignore the farmers’ protest?

https://mymilieu.org/2019/11/17/state-of-indian-economy/

Ideological intolerance
Those who were part of CovidRXExchange may recollect that our efforts were primarily focused on India despite being global. As a pro-bono activity, several doctors and intellectuals invested their time, efforts, and expertise to mitigate the clinical impact of Covid. These contributions were well recognized at several levels of bureaucracy, health, and planning and reflected in covid patients’ upliftment. The sole reason for citing this is that despite being away from the birthplace, we have always attached, but we come with a detachment and see a differing perspective.

I was trolled, belittled, and almost bullied 2-3 years back by my schoolmate when I wrote a critical piece. He and I shared a class bench. Anything against BJP is considered anti-national. You are immediately labeled a Kafir if you oppose or think of opposing any of their ideologies. In fact, this friend also deeply questioned my own commitment to the country, and of course, I was labeled as being under the influence of the Britishers (for reading BBC, the reference cited herein is from Nikkei Asia Review, a Japanese daily, and it is costly, not free). Like religious intolerance, ideological intolerance is fast sweeping India. India is a complex and profoundly diverse country. It is hard to manage the inbuilt controversies if we tend to do with an iron fist. Farmers’ protest is no different in that sense because it is intense in the North but without massive support elsewhere. It will be wrong to say their demands are irrational, but there must be a right way to negotiate and find a sweet spot, a balance that caters to the roadmap. Radical changes always meet resistance, and incremental changes have better adoption.

Trust all the stakeholders strike the right balance. Good luck with that!

Shashank Heda
Dallas, Texas

India braces for mass protests over contentious farm bills
https://asia.nikkei.com/Politics/India-braces-for-mass-protests-over-contentious-farm-bills

Shaking the Citadel of Democracy

We realized the pain of the threat to democracy on Jan 6, 2021, when the Capitol was under attack. Fortunately, the DC law enforcement thwarted an attack on the elected representatives and the Capitol. However, it would have been a tragic accident and a watershed event in the history of the US democracy and an entire experiment of global democracy if the US would have come under authoritarian rule. Fortunately, the US was saved, but Myanmar is an example of where it happened.

In the May 2019 issue of the Diplomat, Jieun Puin warned about China’s increasing influence in Myanmar. Like China Pakistan Economic Corridor, the China Myanmar Economic Corridor (CMEC) has taken a toll on the Myanmar Democracy. It is unwise to exclusively blame the military junta for aborting a democratic election for the coup.

When democracies are trampled and their citadels attacked, it takes away the right of the common-men to decide her/his fate. Democracy offers the common man an ability to coexist with pleural views; an authoritarian or totalitarian system takes away that very right that we all are born with; by no means democracy is a perfect system or a panacea of hope. However, in such regimes, the common man is deprived of influencing his/her collective choices and future.

Word count 992; reading time 5-6 minutes. Why read this article? To understand the fragile dynamics on which democracies thrive. The torment and the anguish of the people of Myanmar are obvious.

Zoltan Barany in the 2015 issue of the Diplomat, had correctly voiced, that Suu Kyi’s NLD government challenges of managing its relationship with the Military, its inexperience with bureaucracy, the deep seated corruption and the menace from China. Almost a week now, the democratically elected government of Aung Sang Suu Kyi’s (pronounced chi) NLD was dismissed. Its leaders rounded up and bolted into confinement. Mother Suu Kyi herself is being investigated for having ten microphones, a high crime and treason?

Burmese Saga is all interesting.
We all know Aung Dang Suu Kyi spent 15 years in solitary confinement under house arrest. A daughter of a martyred military general, she was barred from holding high office since she married a British national. Until the Rohingya crisis ensnarled Myanmar, Suu Kyi was considered an apostle of human rights and rightly bestowed the noble prize.

Buddhist versus Muslim
It is worth lamenting that none of the 56 IOC Muslim countries took the cause of the Rohingya minorities. The Vatican was the first to voice the humanitarian crisis, not considering his faith. It is not news since the refugee crisis that emerged after ISIS in Sudan, and its hinterland consisting of Iraq and neighboring countries broke loose. As though Europe was their natural destination, none of the 56 Muslim countries offered asylum to these refugees. Turkey accepted few but acted more as a conduit and transition hub for these refugees to Europe. Of course, it demanded financial support for taking care of these refugees. At that moment, I felt as though the refugees were abandoned children of Europe that they had to take care of.

How are Buddhist connected to Rohingya?
In a Buddhist majority nation, the infiltration by Muslims from Rakhine province was seen as infiltration. Suspicions of radical activities initiated a spate of violence. Ideally, in my opinion, it was ethnic strife that was colored with religion. Irrespective, Aung Sang Suu Kyi defended its military action at the Hague, which eroded her credibility.

In Myanmar, the Military Junta, also called Tatmadaw, are deeply institutionalized and legitimized through statutes. Any change to the statute needs a 75% vote from the combined elected house. However, the Military has 25% representation on the constitutional bodies (for enacting the law). Simply speaking, it is farcical to think of Myanmar as a democracy. Democracy in Myanmar, like that in Pakistan, is a facade for the Military. Those who are conversant with the Pakistani model of military democracy need no priming on this subject, except that it does not have a gnawing hatred towards India. Like in Pakistan, the Myanmar Military has built deep inroads into various facets of the business. The Junta directly owns State-owned financial institutions.

Mother – More than an apostle of democracy
Suu Kyi is more a mother than just a hope for democracy. While her husband was on death bed, she wanted to visit him in the UK. The Junta gave her a simple option, a one-way ticket to the UK, and renounced her citizenship. She preferred to stay behind for her people, understandably a tough decision.

The Chinese Angle
Under Aung San Suu Kyi, the annual trade volume between China and Myanmar, declined 22.9% to $4.67 billion. Also, Kyaukpyu development in southern Rakhine state, which the Chinese planned as a strategic port with access to the Indian Ocean stalled under Suu Kyi. In recent times, under Suu Kyi, the national debt towards China decreased by 26%. Financial and economic engagement with the west increased significantly. This was a definite threat to the Chinese Belt and Road initiative. At least two ports, one facing the Bay of Bengal (with direct sight to Chennai, Vaizac, and Kolkatta) and the other Yangon, facing the Indian Ocean, are critical for China. Both these ports and the BRI were under direct threat from a democratically ruled NLD government. Destabilization is the cornerstone of authoritarianism, and the Chinese are adept at sowing the seeds of such destabilization. It is equally true that the instability in the Kachin and the Shan State adjacent to the China border, drove several rifuges to the Yunnan province of China.

Aijas Ariffin, https://theaseanpost.com/article/myanmar-crisis-getting-out-hand

Min Aung Hlaing – A pent up lifetime hope
Unlike democratically elected governments, authoritarian governments are ruled by rulers with a long half-life. Putin, Xi, Pakistani Military, North Korea, and now Erdogan are classic examples. Myanmar junta, too, has the same propensity. Its disgraced General from the Rohingya atrocities was about to retire.

A perfect opportunity
Chinese support, tarnished credibility (from Rohingya atrocities), huge loss at elections, and the aspiration to be a lifetime leader all provided a perfect culmination for a coup. Min Aung Hlaing became the de facto leader of the Junta.

Do we have a problem with the Military?
Well, let’s rephrase this. Why should Myanmar being ruled by Military or Democratically elected leader be a global issue? Aren’t militarily ruled nations not properly managed as compared to some of the democracies? I, too, share this concern along with you. However, with authoritarian rule, the mechanism of transparency, audit, and accountability are all vested into a single person’s hands. It is not about corruption, but it is about conflict of interest and the monstrous ability to hide and suppress that compromises the common man’s life.

Democracy gives that right to the common-men to decide her/his fate. Democracy offers an ability to coexist; by no means democracy is a perfect system or a panacea of hope.

Shashank Heda
Dallas, Texas

Who is Myanmar junta chief Min Aung Hlaing? 5 things to know
https://asia.nikkei.com/Spotlight/Myanmar-Coup/Who-is-Myanmar-junta-chief-Min-Aung-Hlaing-5-things-to-know

https://asia.nikkei.com/Spotlight/Belt-and-Road/Renewed-conflict-in-Myanmar-slows-China-s-Belt-and-Road-projects

https://thediplomat.com/2019/05/myanmars-fragile-democracy-needs-the-us-not-china/

https://www.foreignaffairs.com/articles/asia/2015-12-01/democracy-myanmar

COVID- A tale of two worlds

Breaking the transmission cycle by interrupting these traversals of the virus is critical. Travel restrictions, strict screening and surveillance, and mass vaccination and precautions are all CRITICAL to the successful CONTROL of COVID. Let’s keep our fingers crossed and follow all the right protection.

COVID- A tale of two worlds

(Words – 678; reading time 3-4 minutes, Why should you read? The pandemic is not over and out, do not drop the guards)

While the western world is dealing with one of its worst phases of Covid – 19, the so-called Covid-2, several nations, including India, are almost calling the game is over. Let’s revisit and understand the pandemic’s delicate dynamics and the evolving mutant variants of the virus.

As of late January 2021, hospitals in London and its suburbs were out of any beds for admitting the patients infected with Covid. The modeling predicted one of the worst shutdowns in the history of the great kingdom. Boris Johnson, a nationalist and a populist by inkling (a Trump category leader) too, caved into the worst pandemic. My doctor colleagues from Kent are working almost continuous long hour shifts (18 hours at a stretch). Elsewhere in the UK, the scenario was no different.

Brazil has just surpassed India as the second-worst country after the US to be affected by the virus. Europe, with its defining economies, is jettisoned with the virus. France, Germany, Spain, Italy, and all the Scandinavian countries are on the highest alert, with restricted and severely clamped down inbound and internal traffic, almost reducing the countries to secluded pockets.

Here in the US, of course, statistics are grim, the economy has bounced back a little, but guards are not down, like in India and its peninsula. A quick view of the hospital bed availability for most regions, states, and cities are still red, not to mention LA and its suburbs, which is chronically deprived of beds for almost a few months.

Let us unfold the mysterious virus.

While the simmering stories in the western world are true, it is equally true and a reality that life in India (and the peninsular countries) has bounced back to normalcy.

What can be the reason?
Yes, its is an existential dilemma, that has created a completely divided world with distinct response and behavior to the virus.

Continuous mutation and evolution of the virus
While we know all the mutations such as B 1.1.7, D614G, N501, and its variants, and several subspecies of the evolving new generation-of the virus, what is least understood is that avowed variant that is circulating in those countries where life has bounced back to normalcy. Let’s call this hypothetical mystic variant “Benign Covid-21” (I just coined this word, so no Google search will yield any additional documents). This haplotype, if widely circulating in these populations, maybe an answer to the nature mitigation of the virus. Ultimately, as my friend and a noted prominent vaccine expert Dr. Anand Kawade said, the virus has to live amicably with its hosts. It, too, has to find a symbiotic relationship to survive. This metaphysical aspect cannot be discounted though it needs scientific validation.

Should we drop our guards?
It is too early to say if those in India (and countries with a similar pattern of Benign Covid -21, should drop their guards. One thing is clear, global lockdowns (and lock-jams) are definitely not an answer. At the outset of the pandemic, i had called out the hypothesis if the degree of separation concept, retrospectively, in hindsight, it seems obvious to lean and review that model. Summarily, the degree of separation talks about the interaction amongst the population and not the distance that influences the outcome of the disease dynamics during the covid pandemic. Thus, putting entire cities, regions, and states in mass lockdown is not a pragmatic idea.

Breaking the transmission cycle by interrupting these traversals of the virus is critical. Travel restrictions, strict screening and surveillance, and mass vaccination and precautions are all CRITICAL to the successful CONTROL of COVID. Let’s keep our fingers crossed and follow all the right protection.

Shashank Heda, MD
Dallas, Texas
Founder and Chief Executive,
COVIDRxExchange, a global nonprofit initiative for disseminating the expertise and insight for doctors in the care of COVID)

To Visit our repository of over 1000 best practice documents, please visit – http://www.covidrxexchange.org

To join our global community of over a thousand doctors, please use the below link, https://join.slack.com/t/covidrxexchange/shared_invite/zt-le49a2h0-QUsrvUe_5xsdBwgWvEQxrQ

Evangelizing Vaccination

If only we proactively spread the message within our network, engage in an active dialog, resolve the misgivings around the vaccine, start Fastrack the process to curtail the virus. Our ability to bounce back, as a nation and as a community, depends upon how we counter the virus.

The UK is now reeling under one of the most severe public health crisis, not seen since the start of the current pandemic. Despite adequate care, few variants are loose in the community with a propensity for increased transmission, ability to evade the RT PCR tests, cause severe disease and a potential for decreased vaccine efficacy. The later is still under review, while the available data is indicating that the efficacy is probably not compromised.

On Dec 26, 2020, I shared a link associating the variants with the infectivity, implications on testing, therapy, and vaccines. https://mymilieu.org/2020/12/26/emergent-variants-and-infectivity/ Now, these variants are gradually becoming pervasive. In the UK, the lockdown has become commonplace. LA is Southern California, is no exception.

Credit: New York Times, https://www.nytimes.com/interactive/2021/health/coronavirus-mutations-B117-variant.html

As the mutant variants in fast-moving across communities, they will strengthen by our resistance to vaccinate. I shared another link, https://mymilieu.org/2021/01/28/a-triple-whammy-variant-vaccination-and-complacency/, that provides a simple explanation on how vaccination will halt the spread of the virus. The medical community and other healthcare workers have to put all their might to counter the anti-science (believes) and the rumors generated from conspiracy theories to increase adoption of the virus. However, the responsibility falls on all the elites, not just those from medicine and allied faculty, to spread vaccination.

If only we proactively spread the message within our network, engage in an active dialog, resolve the misgivings around the vaccine, start Fastrack the process to curtail the virus. Our ability to bounce back, as a nation and as a community, depends upon how we counter the virus.

Do COVID Stories Matter?

Sharing a story from a doctor’s family from the UK

The Pathologist lost her elderly doctor parents at a gap of two days. The Pathologist herself got Covid second time since she was not vaccinated. Her husband too got Covid. This is the new variant.

How do we use this information?
It is important to take the vaccine. Vaccination stops the virus from multiplying. No multiplication means no further mutations. So those vaccinated are better off. Now, does that mean vaccination won’t have adverse events? Let me say my parents, 84 and 78 had none. Some may have arthralgia (joint pain), fever, injection site pain or tenderness, lassitude etc. These are anticipated response to the vaccine. However, do contact your doctor, they will do their ‘due diligence’ but do not panic. Take Tylenol, rest (sleep) and healthy food while you schedule with your doctor.

Should i stop using masks after vaccination?
No, at least so far, science does not merit the discontinuation of masks. Also, check Federal, State and Local guidelines. The Biden administration is making mask wearing more stringent.

Is mask sufficient?
If you are visiting crowded places, closed spaces outside your bubble, people outside your bubble, wear double masks and use protective glasses/goggles. If i step outside for a walk, i use KN95 inside and Surgical (blue white) mask outside.

Is that enough?
No, remember, if you are breathing, you are transpiring air in and out. That also means you may transpire viruses, if those are in the vicinity.

What do we do?
Limit your exposure as much as possible. Yesterday (Sunday), I had a senior industry leader going for shopping/grocery. When asked why? He said, bro we have to eat! You can get home delivery, you can shop when on weekdays, before 2/3 pm when the traffic is light. Avoid Saturday/Sunday.

But there was no one around
Well, we all know, asymptomatic carriers too can shed viruses. How can you say, i am not expelling viruses?

Don’t Second Guess and Don’t Drop your Guards. You have a family to care.

(On behalf of CovidRxExchange)