In Search of a Haplotype

The new variant of the virus has already spread out to over 45 countries. While scientists are understanding the impact of the mutant variants, what should we do as individuals and societies to counter the potential threat from the virus?

In this article, I have provided an insight on personal and administrative/social preparation that needs attention.

(Word Count 942, reading time 4 -5 minutes).

By now, we all know the virus is mutating, and mutating every few weeks. For those who are not aware of what a mutation is, it is a change in the genetic program embedded within the virus. However, only a few mutations have possible implications on the infectivity, ability to induce severity, response to the drug, and the response to vaccines. All of these are critical for individuals, families, and society in general. Of course, everything is intertwined and ultimately has an impact on the socioeconomic structure. We have seen the devastation of several families. When the virus went on the rampage, we saw how the economies faltered and GDP’s collapse.

Variants and their implications

We all know that the UK, EU, and the US are badly reeling under the virus. Hospital beds and ICU bed availability in many regions are critically stretched, and so are the human resources like HCW. London Mayor Sadik has already implemented a lockdown with punitive citations for overriding the lockdown. Rightly so, despite our freedom mongering and yearning for personal freedom, we ultimately land up with the hospitals.

At least three variants are known with possible implications on the infectivity, severity of the disease, resistance to drugs, and efficacy of the vaccines. N501, B1.1.1.7, D614G and A222 are mainly prevalent in the UK, South Africa, and the EU. All these variants are known to be more contagious than the wild type, that is universally prevalent. Also, a collaborative study between Duke University, Los Alamos National Laboratory and Sheffield University has revealed that D614G variant is associated with higher viral loads in the upper respiratory tract. As of now, we are not yet sure if there is a variant that exists in LA and other parts of the US that are reeling under the virus. At least 45 countries have so far reported the presence of these new variants as of Jan 10, 2021. The National Laboratories from individual countries are searching for the virus’s existence within their societies and implications if any.

Japanese National Institute of Infectious Disease has similarly identified a new strain after the Japanese Government realized passengers’ arrival with the variant viruses. Naturally, the imposition of a ban on incoming flights from infected countries is the first knee jerk response. Many countries have reimposed the ban on travel from those countries with the presence of this virus. While the respective Governments are working to identify the new virus variants, individuals and the administration should gear up to deal with the increased threat level.

Credits: News Medical Lifesciences, Dr. Liji Thomas, MD. D614G mutation now the dominant variant in the global COVID-19 pandemic
  1. Individually, we all should follow the precautions stringently. Masks, social distancing, and containment strategies such as quarantine are basic. However, never presume that asymptomatic individuals are non-infectious. Research has proven without a doubt that asymptomatics are the ones who are spreading the virus. It goes beyond saying that kids harbor more viruses and remain asymptomatic. Kindergarten and schools can be the potential source of spread. While many schools have opted to go into virtual schooling, it is challenging for the daycare centers to do so. It is best to huddle into your bubble and only interact when it is essential or critical, understanding that those interactions should follow the strictest precautions mentioned above.

Vaccines
Vaccines are derived based on a certain genotype of the virus. If the virus changes its structure, the vaccines may have a potential dent in its efficacy. Second, vaccines, even if they are efficacious, may protect only the ones who are vaccinated. Vaccinated individuals may still harbor the virus. Thus, protection has to continue despite vaccines.

  1. City and Corporation Planning – Many cities, especially in South East Asia, are basking and boasting their success with COVID-19. COVID-19, as well all know, can strike back anytime. Complacency is not alone a defunct but also a counterproductive strategy. Europe and other countries undergoing a severe COVID-19 pandemic spike have realized how the spike overstretches the HCW. Doctors are overburdened, and so are the supporting staff.

Realistic modeling of the unfolding second spike is critical. R Naught, which was widely used at the pandemic initiation, has been revealed to have several flaws. It only threw our economy into shambles and society into unrequired chaos. Newer modeling that is closer to realism is the need of the time.

Second, the infrastructure that was propped up during the pandemic’s initial phase helped but was not necessarily sufficient. We need to identify a more long term viable solution to our healthcare services to deal with the virus. Using the same knee jerk response is unlikely to provide an adequate safeguard. Mere lockdowns are too insufficient and, at best knee jerk; we need more than a rational response, now that we know the pandemic better from our recent experience.

  1. Society – Herd Immunity
    Sweden, the UK, and the US are great examples that serve as potent examples that herd immunity is not enough. It does not offer protection without collateral. The collateral is the death and devastation of an individual with a permanent compromise with residual sequelae on health. Those who survived COVID-19 are physically either compromised in functioning or occasionally rendered dependent on supplemental oxygen.

The only and ultimate panacea would be a natural selection of a haplotype (a genotype) that would be less infective, cause inconsequential disease, and still respond to drugs and vaccines. The emergence of such strains is a natural selection process. The virus will possibly realize that if it has to cohabitate like several other bugs, in a symbiotic relationship with human beings.

Shashank Heda, MD.
Dallas, Texas
(For COVIDRxExchange, a global nonprofit initiative for disseminating insight and expertise in the care of COVID)

https://www.lanl.gov/discover/news-release-archive/2020/July/0702-newer-variant-covid-dominates-infections.php

https://www.news-medical.net/news/20200925/D614G-mutation-now-the-dominant-variant-in-the-global-COVID-19-pandemic.aspx

What’s So Gilded About the US democracy?

Why not? What’s so gilded about US democracy?

The epithet is resounding; it happened in America. Well, as though the US was fire-walled from such happening. The effigy of what happened on Jan 6, 2021, was written on the walls. It was brewing, and the tinder just required a fire. Trump represented a perfect example of that fire exploiting the raw sentiments.

I wrote this earlier, and I will rephrase it again. What happened on 1/6/21 is an expression of severe discontent, propelled the capitalist leaning philosophy. Readers may be wondering why a capitalist philosophy is responsible for the mayhem. Well, let delve deeper –

Let us look closely at the pictures of the mayhem at the Capitol and then reflect on the ultra-right roaring sensationalism; the root cause of all these lies in the loss of opportunities. This loss of opportunities created a huge swath of “Have Not’s” that ultimately led to the fusion of an ocean comprising of the rust belt, farmers, small businesses, farmers, and several legacy businesses that relied on an older model of businesses that made America Great! Those models were dismantled, not deliberately but with an imperative, to accommodate change, and change is imperative.

Inadequate Retooling
In their haste to remodel, the capitalist chose an easy path, a grotesquely unjust path of not retooling the skills. I will cite a few examples of those. When NAFTA was formed, the US and Canada wanted access to Mexico’s wider customer base for their industrial products. As collateral, the agricultural sector was compromised. The produce and crop that was hugely productive in the US moved beyond the borders and deprived the ordinary farmers of their livelihood – thus creating a bubble of discontent. Ideally, these farmers should have been retrained to do value-added agribusiness or alternative profession.

Another wave followed – to counter Russia’s threat, the US and the West propped up China. China, a ragged country with a dismal per capita income, became a cheap fuel source for manufacturing industrial and commercial products. Again, another bubble of discontent created what we call the rust belt. The discontent kept growing and simmering, ignored by the elite and the by-lanes of power.

Another bolt came from the emergence of Automation of Information Technology and Knowledge Workers. Educated and trained white-collar landed is swaths from India, South East Asia, and other countries. That workforce bolstered not just the IT and Knowledge Industry; it also propelled the GDP of the nation.

Not that the US had a dearth of Knowledge and Technologist, however the white-collar, who flew in droves, disrupted the entire work-life balance and created an alluring competition amongst the workforce, enticing the capitalist for cheaper and sometimes optimal labor. It was easy to invite immigrants to work here. After all, it takes years of investment to make a knowledge worker, rather than invite one to work. The capitalist chose a shortcut by again not retraining their folks and falling to the allure of draining the white collar from the poor, ramshackle economies.

Such bubbles kept growing, simmering, and sizzling. Discontent kept coalescing, widening the chasm between the vast ocean of “Have-Not’s” versus the “Have’s.” If I may venture, the republicans kept stoking that fire and exploiting it further.

Emergence of Trumpism
Trump is an expression of this discontent. As a smart businessman, he perfectly exploited the opportunity and got ensconced as the fountainhead and a leader of these marginalized blue-white-agri collar workers. The problem of making “America Great Again” lies in addressing these root causes. It will take years to heal the infractions and propel the nation forward on the path towards progress.

This challenge needs to be addressed by Joe Biden if he has to represent and stitch the nation as a whole.

Shashank Heda,
Dallas, Texas

I’m reading It Happened in America via the ForeignAffairs app
https://reader.foreignaffairs.com/2021/01/07/it-happened-in-america/content.html

The hooligans of billionaire

While the ceremonial proceedings of accepting the newly elected Presidents were being conducted in the pulpit of democratic temple, an absolutely brazen act was unleashed by Donald Trump on the Capitol. The moment of truth has come, Joe Biden is now the President of the US.

Though such act throws us into revulsion, and it is easy to castigate the poor and the wrongly guided mob that burst out on the Capitol. However, it is yet another reflection of two things – of the widening chasm between the have’s and the Have Not’s and those who are ready to exploit the chasm.

President Trump has to provide an explanation. It is a must that he be removed even though only 13 days are remaining for his presidency to end. We never know what harm he will inflict further.

Excerpts from New York Times below –

Deplatforming: After the mayhem on Wednesday, the president was suspended from Twitter for 12 hours and from Facebook for at least the next two weeks, but Greg Bensinger argues in The Times that the bans should be permanent. “Jan. 6, 2021, ought to be social media’s day of reckoning,” he writes. “There is a greater calling than profits, and Zuckerberg and Twitter’s C.E.O., Jack Dorsey, must play a fundamental role in restoring truth and decency to our democracy and democracies around the world.”

Unleashing hooliganism on Capitol

By all means, the hooliganism at the Capitol is equivalent to treason. It is an act of sabotage and it should be treated appropriately. Those nay Sayers, let me ask you – If I were to provoke such act any legislative premise, threaten the lawmakers, ransack the house, and injure policeman, do you think I should be pardoned?

By no means, everyone should have a similar treatment in the eyes of law.

Shashank Heda,

Dallas, Texas

Pro-Trump mob storms Capitol, disrupting electoral count
https://asia.nikkei.com/Politics/US-elections-2020/Pro-Trump-mob-storms-Capitol-disrupting-electoral-count

Clemency, Exoneration, or Pardon

Stretching the maximum limits

I am not a student of law, so my concerns are at best gullible. Not that I haven’t heard clemency, exoneration, acquiescence or pardon for the first time. However, reading this news from NY Times, made me reflect on few issues on pardon –

  1. Pardon is essentially a post facto dispensation of a crime that has happened earlier in the temporal scale. That means, a crime is committed earlier and eventually, in rare circumstances, a pardon is considered and occasionally granted.
  2. Pardon, thus has an implicit submission of the occurrence of crime. It needs a bonafide evidence from jury to have established a crime, not just a suspicion of crime.
  3. As i understand, laws are universal and applicable to each and everyone, no one is above the law. At least that’s the prevailing understanding.
  4. Conflict of interest is strongly likely to create a bias and thus, to avoid a bias, building a neutral design to review the facts is critical to provide validity and moral standing to the disposition and outcome.
  5. Preemptive Pardons are this a criminal offense if one enjoys the status before intending to enjoy the privilege of indulging in a crime.

Trump’s self-pardon is thus unprecedented, it is an abrogation of the natural system of justice. It does not matter if the above five design principles cited by me are mentioned in jurisprudence and statutes of this country. It is, irrespective of its articulation, devoid of moral.

Should we stick to statutes and laws, or review the extraordinary instance as a precedence that some one taking cover and camouflaging oneself? Should we let this person escape because there is not enough built in safeguard in the system to do the diligence and decide and outcome?

I find it vertiginous to think of a self pardon. May be, let’s see how and what the law interprets this. It is stretching the limits of morals to the maximum.

Shashank Heda,
Dallas, Texas

Coup d’etat

While a pseudo coup d’etat was being attempted at the global Capitol of democracy, the actual coup was pulled by China with the signing of the deal with Europe.

We deride Trump for whatever he did or whatever he is doing, but understand, Trump is a reaction to current challenges.

There is a certain homeostasis or a balance that works within nature and when that balance is perturbed, things go topsy turvy. No sane leader could counter China as much as Trump did. At every level – strategy, tactical or operations, he embedded right momentum to browbeat China, and right so, it is required.

It was pretty much evident, that a similar alliance, if persistent, could cordon off a sequestering philosophy of an aspiring middle kingdom to dominate the world.

Most economic coffers were after getting dried up, with the unleashing and smoldering from the pandemic. Chinese debt, was rising significantly from all its (mis)adventures – Ghost cities, BRI, Global ports and Sea Lines or the South China Sea debacle.

It was increasingly getting evident, that with the drying or the customers and the mounting debt, China would succumb under its own weight.

However, with the inking of this deal with EU, China has garnered a huge customer base to bail itself out of the current morass and get a reprieve from its crumbling weight of debt.

This coup d’etat was certainly beyond the radar and it was certain a surprise.

Shashank Heda,
Dallas, Texas

Analysis: China splits Atlantic with game-changing EU investment deal
https://asia.nikkei.com/Editor-s-Picks/China-up-close/Analysis-China-splits-Atlantic-with-game-changing-EU-investment-deal

The Stockholm Syndrome Revisited

Well, let me caution the use of language, Trump’s language from 2016 GOP primaries. During along with nine member debate, Trump said Ted Cruz, the senator from Texas, had a very small phallus. As if that was not enough, low energy and other rants were hurled at his GOP competitors. Today, after living with the Trump Captivity, Ted Cruz is ultimately a transformed man. Along with his Cabal, he is ready to disqualify a correctly conducted and court(s) validated outcome that Biden has won. Cruz and Cabal want those results thrown out and desperately want Trump to run the show at the cost of the nation.

What’s behind it?
Stockholm Syndrome is a survival mechanism. If you review the psychodynamics, you realize that a continuous opposition and despise of those keeping an individual in captivity plays deeply on the morale of the hostage. Feigning that they are ok superficially and having a deep discontent internally are likely to create cognitive dissonance. Cognitive dissonance is a deeply demoralizing phenomenon, and the avoidance mechanism kicks in. That’s the transition that brings the alignment between the captor and the captive.

Gains? Rewards?
Simple, even if it is not Stockholm Syndrome, who would not want to inherit the legacy votes that Trump garnered? That’s the ruthless politics that people indulge, for political survival, even at the cost of the nation. Or maybe they know, let me play that role, some good cop may eventually come to the rescue. But it is worth inheriting that huge chunk of votes for future elections. Why squander?

850 Million Dollars?
As the Senate seats are being contested in Georgia, almost 800 plus millions have already been spent, for an outcome that was hardly a surprise. Democrats are leading both the seats, and it will provide a sway for President-Elect Biden to pass his policies.

Let’s hope for the best!

Shashank Heda
Dallas, Texas

More than 9/11

Well, 9/11 was a defining moment in the history of the US. Today was a most prominent landmark, an assault disproportionate and incomparable in any sense with even a nascent democracy from Africa.

A Dark Day in our modern history

Despite multiple thorough due diligence, court validations, and immense pressure on officials to reject the people’s verdict, finally, we came to a nail biting event of violence being unleashed on the sanctum Sanctorum of not just the US democracy but the entire global ideology of democracy.

An assault on democracy –

While the Georgia Senate runoff is being counted, and while both the chambers were going through a debate on approving the electoral count, precisely at that moment, all we see is demonstrators loyal to President Trump, creating mayhem by entering the capital building. I have a few Concerns – it was clear since morning that a crowd had gathered to protest both the houses? How could they arrive suddenly into the capitol building? Let’s imagine they would have surrounded Pense. Were they planning to ask him to disapprove the electoral votes? If that would have been done, have we missed our spot in the history of capsizing democracy?

Below, excerpts from select lawmakers –

“Today is a sad day for our country. The destruction and violence we saw at our Capitol Today is an assault on our democracy, our Constitution and the rule of law, and must not be tolerated,”

“Thugs assaulted Capitol Police officers, breached and defaced our Capitol building, put people’s lives in danger and disregarded the values we hold dear as Americans,”

“insurrection incited by the President of the United States. Those who choose to continue to support his dangerous gambit by objecting to the results of a legitimate, democratic election will forever be seen as being complicit in an unprecedented attack against our democracy.”

As though SARS CoV2 was not enough

We all know SARS CoV2 binds to ACE 2 after priming by another protein called TMPRSS2. One latched on, it establishes itself inside the cell and uses host machinery to make next generation or progeny.

The virus has a defective gene called RDRP, which creates errors in proof reading and consequently coronavirus -2 keeps accumulating mutations faster. The vast majority of mutations provide no advantage to the virus and die out. But mutations that improve the virus’s fitness or transmissibility have a greater chance to increasing infectivity.

This is exactly whats happening with SARS CoV2. The 17 mutations confer another survival advantage to the virus. One such mutations confers additional affinity for the S protein to bind to the ACE2 receptor.

To recall, a sneeze of an infected person blows almost 4.5 to 10 million copies of the virus. We also know that these numbers may scale up-to 54 million in one bout of coughing. As though that is not enough, we know that a virion can produce 100000 copies in just over 24 hours.

All it means, the precautions we followed to stay safer and all the more relevant now, plus limit the exposure (despite masks and distancing) to not more than 15 minutes.

Of course, immunity and mental health plays a significant role in fighting the virus. While some may interpret immunity as gulping a few pills, the actual benefit comes from being physically active.

Another aspect that kills your immunity is depression. While there can be several factors involved in the causation of depression, it is best to teleconsult, and mitigate that. It is important to stay healthy – both physically, mentally and spiritually.

Thus, prevention comes from dual action – stringently following precautions and keeping yourself healthy.

Shashank Heda, MD
Dallas, Texas

Rubber Meets the Road.

Let’s start where I want to end this topic, and I know you won’t like me saying this. The pandemic is likely to swagger around more than anticipated. If we anticipated it to end sooner, if not early 2021, it bores disappointment. It’s just not the delay in rolling out the vaccine. Let’s see the multitude of issues why the pandemic is likely to last longer.

Vaccine Nationalism is an integrated world is unlikely to protect a nationality unless the borders are strictly closed. Well, any isolationism and walls are unlikely to stop the Humboldt of global integration. If the rich or the have (those with technology), are planning to cover their nationals, the virus is likely to linger longer in those deprived.

What are the consequences?

Most of us are aware of the new mutations in the virus that imposed an immediate lockdown in the UK. This mutant variant is secondary to the virus gaining survival by mutating and escaping. Such mutants are like to hamper our interventions right from screening to vaccination.

Is it a global vaccine rollout?

Of course nor, the vaccine rollout has started in the EU, UK, US, Brazil, Mexico, Canada, Japan, China, and a select few countries. However, several countries are lagging behind either because they have no funds or no technology or logistics to deploy a complex vaccine delivery program. Add to that the regular protagonist of the ‘conspiracy theory’ school, and you compound the problem to a level of practical reality.

Surprise – Many doctors are evading vaccine

I was surprised to see practicing doctors avoiding vaccines. This is not an isolated but a pervasive phenomenon. There are still lingering doubts about the virus getting integrated into the human genome, which is unlikely to happen. Another misconception is heavy metal contamination of the vaccine. You and I are more exposed to the unknown quantity of heavy metals in our produce from Mexico or the disposable material we are exposed to. First, I may disagree if such contaminations are possible with the vaccines, and even if those were, it is unlikely that you get a significant dose to perturb your system. Another misconception that is going around – that the vaccine is made in cow or pig. I just piety these folks who work on churning the rumors mills devoid of research, reasoning, and rationale.

The cold chain and logistics

It is a formidable challenge to manage the cold chain in a diverse world like ours, even if we presume that vaccination will be adopted uniformly. Having worked as a molecular oncology fellow, I know that especially the RNA vaccines from Moderna and Pfizer need a distinct cold chain, and any disruption is likely to compromise the efficacy of the vaccine significantly. Now consider the vast and remote corners where the vaccines have to be carried out if we were to target complete eradication of the virus.

These are not easily surmountable challenges and devoid of a strategy and execution plan that is customized to individual locales (countries, regions, etc.), it is unlikely to achieve the desired goal of covering 60%-80% population. If the virus lingers, it will mutate and likely stay with humanity for longer than the expected period of time. It will evade our detection gold standard, such as RT PCR. It may create resistance to drugs such as Remdesevir, or worst, become more aggressive and, last, render our vaccines useless. That’s why we vaccinate ourselves annually for flu.

Let us hope for the best.

Hope is not the best strategy; instead, hope is the worst strategy. A thorough understanding of the global target population dynamics vis a vis the vaccination program is required. Strategies alone cannot help; execution of the plan will be the harbinger to success. Until then…

I wish you all a very safe 2021!

Shashank Heda,

Dallas, Texas

The Culpable Trend Continues

Of course, we saw during Covid how China suppressed the Covid investigation, manipulated the data and cleared the crime scene.

Recently, I saw news that China is targeting a GDP of 8 and above fir 2021. It is no news that China is under severe debt, industry is recuperating to gradual recovery, (and of course it will be, because its global customers are still reeling under recession), and it has quadrupled its expenses during a time depleted revenue flow and persistent pressure of aggressive spending on aggressive militarization.

Credits: John H Tuckers, The Riverfront Times

Now comes the real news

It has suspended the regulating agency which rates the progress. And why not? It has to, if it needs to pain all hunky dory, like the old style communist propaganda.

Eventually, we know, with one stroke of Perestroika, the entire communist castle came crumbling down. It’s just a matter of time, such artificial models have no sustenance, they glitter like a nighttime bugs, and lose the flare with the arrival of twilight.

Shashank Heda
Dallas, Texas

Chinese regulator suspends rating agency over Yongcheng default
https://asia.nikkei.com/Business/Markets/China-debt-crunch/Chinese-regulator-suspends-rating-agency-over-Yongcheng-default