FM February Edition 2021

₹ 250.00
VOL 7 | ISSUE 10
PAGES 100
February 2021
FUTUREMEDICINEINDIA.COM
WELCOME
TO DESI
JABS
INDIA BEGINS MASS IMMUNISATION
AGAINST COVID-19 WITH TWO
INIGENUOSLY MADE VACCINES,
AMID DOUBTS ON THEIR EFFICACY
IN THE NEWS RESEARCH TECHNOLOGY COVID-19 UPDATES
DOCS QUESTION
VACCINE SAFETY
GAME-CHANGING
mRNAs
NANOTECH GETS
A BOOSTER
FROM COVID-19
VAC IMMUNITY TO
LAST FOR A YEAR

editor’s note
February 2021 / Vol. 7 / Issue 10
Founder & Managing Editor
CH Unnikrishnan
Executive September Editor 2020 / Vol. 7 / Issue 5
S Harachand
Founder & Managing Editor
Science CH August Unnikrishnan
Editor 2020 / Vol. 7 / Issue 4
Dr
Executive
Rajanikant
Founder
AUGUST
&
Editor
Vangala
2018
Managing / Vol:
Editor
Associate S 5 / Issue: 4
CH
Harachand Editor
Unnikrishnan
N S
Science
Arunkumar
Executive Editor Editor
Copy Dr S Rajanikant Editor
HarachandVangala
Sreejiraj Consulting Eluvangal
Science Editor Editors
Consulting Dr Dr Shivanee Rajanikant Editors Shah Vangala
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Consulting Editors
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Dr Founder Shivanee & Editor Shah
Design Copy Jeetha Editor
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CH Unnikrishnan
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Curator-cum-Correspondent
Design Copy Executive Editor Editor
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Harachand Eluvangal K
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editor’s note
Dear Doctor,
editor’s The 148-page note operational guidelines on COVID-19 vaccination released by India’s
ministry
editor’s
of health
note
and family welfare in December, anticipating the arrival of the
new Dear vaccines, Doctor, is aimed at helping you become a part of the country’s immunisation
programme Dear Doctor, as both a receiver as well as a vaccinator.
My daughter, like every other urban, school-going child, had hardly any time to
However, Perhaps against theory most is often our simpler expectations, than practice, we still and find this ourselves adage in has the again middle been
sit unengaged. Besides endless academic chores, including the hectic homework of
proven a raging by pandemic. the recently Like begun everyone vaccination else, you too drive are against exhausted COVID-19 with all in the India. options In the
and soft skill projects and presentations, she also found time for her painting and
first for disease 13 days management of the programme, laid out India before could you. only However, vaccinate the fact slightly is that more symptom than 2
dancing classes. In between all these edu-arta-thons, she would also invariably
million relievers people
Dear and Doctor proven out of and the unproven 30 million immunity health workers boosters who are the form only the options overall in target front for
squeeze in her favourite sports and workouts with school and building buddies,
the of the first infected, phase. Though and that it the is too pandemic early to remains determine as untamed success as and ever. failure, All hope the now pace of
of whom she has many. But, COVID-19 has put a stop to all that. The lack of the
the rests
usual
programme on
We opportunities
a potential definitely vaccine.
know you are for busy. action,
seems But
It is with
how slower
always classes
close than are
reassuring confined
we expected, to that
that to the
panacea considering
trust internet
really?
and and,
that Not
faith most
the very,
of of
plan
all,
was to be frank, but not very far either.
the hundreds relentless
for covering
of confinement
at least 300
patients in at your home,
million
healing often
people
touch leaves
— including
keeps her moody
healthcare
you busy and in glum—a
forces,
this noble typical
other
frontline Indeed, the latest WHO survey has a list of 165 SAR-CoV-2 vaccine candidates
psychological
workers
profession. syndrome
and the
under development In the across hectic that
ill and
the practice, affects
old
the
— over
world. At it’s ‘normal’
the first
least quite 23 natural people
five
of them that exposed
to six months.
are you in clinical might to ‘abnormal’
Potential
trials miss
recipients, and
situations. including
six are out in on This
final some pandemic the more
stages, of the including latest and informed
developments the prolonged healthcare
phase-3 human in lockdown professionals,
studies. emerging is nothing
Eight medicine. less are not
vaccine candidates In than turning
this era a very up
as ‘abnormal expected.
are in of various innovation,
situation’ This is despite
stages medical
for not
of development science
just scarce her, resources
is
but getting
millions being
India too. redefined
of children laid out
Of these, almost
and the
two by
adults hope
are the already day.
across that around
in Old
the
300,600 world. people could have been immunised on the first day itself, and similar or
higher phase-1 technologies human trials. are being The Oxford-AstraZeneca replaced by the new vaccine, the which blink is of presumably an eye. Robots the
The volumes repercussions would and continue manifestations in the following of this prolonged days. abnormality in our
front-runner and artificial among intelligence the four global are taking candidates over a in good the part most of advanced the procedures, stages, has
now
social When
while been
life the vary country’s
genomics allowed
from
to
person drugs
and be tested
to regulator person.
molecular in India.
These announced
science The unveil Indian
include the
the manufacturing
anxiety emergency and depression use authorisation
mysteries of partner life further. of
as
for
the
well Covishield
We British
as biological and
are vaccine
effects Covaxin
fortunate project—Serum
like — disturbed the two locally
to have such Institute
sleep, manufactured
breakthroughs of India
appetite
— as will
disturbances vaccines,
they conduct help specialists the
and many
observerblind,
other
expressed like
emotional their
you
randomised
difficulties. reservations
rise above
controlled
The severity over the
the expectations
study
may ‘hasty’
to
of
determine
even extend manner
today’s informed
the safety
to in mental which
patient.
and immunogenicity
illness the vaccines and even had
been
of substance given
the vaccine misuse. the go-ahead
candidate The young by authorities.Not
in about and 1600 the old, healthy pregnant surprisingly,
human women, the
volunteers family government
in the members campaign
country. of
has
However, the not infected been
this and is
able
only those to
the
live who second
upto have expectations.
phase died of due human to Rather, trials, infection it
and
has
they
failed and will even to
move
generate the to lonely
enough
Phase-3 are Similarly, all vulnerable confidence
only
it
when
is also to the
in mental a the
company
time public health when
is
and
successful issues India even is caused witnessing among
in submitting by healthcare the revolutionary pandemic safety
professionals.
data, and growth
evaluated society’s in So,
in by reaction a the healthcare way, Data to scarce it. Safety industry, resources Monitoring especially and Board infrastructure (DSMB), the private to mobilized the sector, CDSCO—the wherein for the Indian drive increasing is drugs being
underutilized, regulator. One number of the of most with doctors no crucial fall-back are areas taking plan. we up must Our multiple cover focus roles on story is of the chronicles clinician, psychological researcher the practical impact and that
problems this These entrepreneur. has on promising that the ail first ‘the This advancements response world’s requires teams largest’ expansion by like the immunization you scientific of and your your community focus drive. colleagues. to a wider worldwide The canvas. long are In hours
certainly spent A this special working context, commendable. report in it potentially on becomes accelerated But, important dangerous what we investment seem how and to a unpleasant busy be in AI losing professional and sight situations, nanotechnology in like all such you this as can are as testing a the
fallout very labs, keep real hospital from challenges pace COVID-19 wards with these and is risks another COVID latest involved ICUs, developments interesting makes vaccine frontline read development. a quick this health edition. and workers The easy We development
way. prone also explore to such
the of mental a promise safe health vaccine of issues. cyanobacteria typically In this a edition, long, — a largely complex we wanted unexplored process to highlight and natural often the lasts resource ground 10-15 offering realities years
a and on potential this
At involves Future
front gold multiple and
Medicine, mine the elements paramount of which new pharmaceutical is of conceived
importance research and and
of compounds development providing
crafted by
additional
a and team drugs various of
mental
senior even levels for health
cancer of support public and information private participation. to both the Therefore, care-seeker this rapid as well race as and the the caregiver. shortened
journalists, and other scientists yet unaddressed and doctors, diseases. our aim In is Holy to help Grail, you Dr do PR just Sodani that. of We IIHMR
University, process Another is certainly highlight not of the this desirable edition is way a report to go on forward, a genetic but study we do on need the a NCD-hit solution
are equipped
the country’s
to bring
best
you
public
the latest
healthcare
from the
research
science
and
of care
management
from across
institute,
offers urgently. South his Asian That, tips population—uncovering to however, make the doesn’t COVID answer vaccination the the story question programme behind of whether first-ever more such focused Genome-wide
a rapidly and
developed Polygenic
the world
Risk solution
in
Score
an
will
interesting
for be coronary 100%
and
safe artery
convenient
and disease efficacious.
way,
on the
supplemented
In this South edition, Asian we
by
population. delve
the best
effective. Of course, an increased spend on vaccine development, immunisation Dr
deep V Ramprasad, of into views the and high-wire CEO analyses of MedGenome, acrobatics from the that masters which is COVID-19 initiated each vaccine the field. CAD We development.
PRS present study, you also this
and healthcare capacity building announced the Union Budget is a booster. talks
about Also specialised the in this greater edition knowledge impact is a special that vehicle it feature can that make plugs on the in India, you latest into scientific Straight the emerging advancements Talk of world this edition. of
Here’s a most care wishing promising seamlessly. you cardiovascular insightful Come, let’s reading, treatment join hands involving this information one-time gene journey. editing. Our
Wishing you an insightful reading,
guest on Straight Talk this month is Sameer Sheriff of iPC Health who explains why
we need CH Unnikrishnan
to get a grip on India’s high levels of medical error deaths urgently.
Wishing editor@futuremedicineindia.com
you an insightful reading,
C H Unnikrishnan
C editor@futuremedicineindia.com
H Unnikrishnan
editor@futuremedicineindia.com
C H Unnikrishnan
editor@futuremedicineindia.com
www.futuremedicineindia.com futuremedicineindia FutureMedIndia
AUGUST 2018/ FUTURE MEDICINE / 3

IN THE NEWS RESEARCH TECHNOLOGY COVID-19 UPDATES
Vol 7 Issue 10
February 2021
DOCS QUESTION
VACCINE SAFETY
GAME-CHANGING
mRNAs
₹ 250.00
VOL 7 | ISSUE 10
PAGES 100
FEbrUAry 2021
FUTUrEMEDICINEINDIA.COM
WELCOME
TO DESI
JABS
INDIA BEGINS MASS IMMUNISATION
AGAINST COVID-19 WITH TWO
INIGENUOSLY MADE VACCINES,
AMID DOUBTS ON THEIR EFFICACY
NANOTECH GETS
A BOOSTER
FROM COVID-19
VAC IMMUNITY TO
LAST FOR A YEAR
22
FM COVID-19 UPDATES
IMMUNITY FROM
VACCINE WILL
LAST AT LEAST
ONE YEAR:
MODERNA
REGULAR FEATURES
06 Letters
08 News updates
48 Drug approvals
58 Research snippets
63 Hospital news
64 Drugs
68 Devices&gadgets
72 Gynecology &
paediatrics
74 Guidelines
96 Calendar
97 Book review
98 Holy grail
Columns
35 TRIALOMICS
Dr Arun Bhatt
62 THE CELLVIEW
Dr Rajani Kanth Vangala
14
IN THE NEWS
DOCS RAISE
CONCERN OVER
VACCINE SAFETY
Even as IMA endorses the safety of
Indian vaccines, a section of doctors
fears the “inadequately tested”
COVID shots
54
STRAIGHT TALK
“DATA PRIVACY
IS THE MOST
CRITICAL
ISSUE THAT
VIVEO WANTS
TO ENSURE”
Raul Kallo
CEO & Founder
Viveo Health

32
RESEARCH
GAME-
CHANGING
mRNAs
The potential of mRNAs can be
effectively harnessed to target
genetically unique cancer cells
36
COVER STORY
FIND YOUR
PLACE IN THE
VACCINE LINE
India flags off the ‘world’s largest
COVID-19 vaccination’ drive,
even as critics doubt
the efficacy of the desi shots
18
TECHNOLOGY
COVID-19
TRIGGERS
ACCELERATED
INVESTMENT
IN AI, NANOTECH
Economic forecasts
say the fallout from
COVID-19 is driving huge
investment within AI and
nanotechnology
mRNA and vector
technology can
readily be adapted
to effectively
respond to escape
mutations of
SARS-CoV-2
Dr Helmut Brunar
CEO, Viravaxx AG

IN FOCUS RESEARCH REVIEW COVID-19 UPDATES
letters to the editor
SHIGELLA SCARE
IN KERALA
HIJACKING
COAGULATION
VACCINES
SO FAR
₹ 250.00
VOL 7 | ISSUE 9
PAGES 100
JAnUAry 2021
FUTUrEMEDICInEINDIA.COM
THE RISE OF
mRNA VACCINES
mrnA VACCInES FOr COVID-19 KICK OFF A nEW ErA.
CAn THEy BE A PAnACEA FOr OTHEr DISEASES TOO?
LLAMA ANTIBODIES
TO FIGHT COVID-19
Keep safe with masks
Sir
The currently approved
COVID-19 vaccines are
known to be very effective at
preventing severe infections
and death. If sufficient
numbers of people are
vaccinated and immunised
against this virus, we might get
this pandemic under control,
and prevent an enormous
amount of human misery,
deaths, and future chronic
medical conditions that have
been linked to COVID-19
infections. However, this postpandemic
scenario will not
arise immediately and there
are uncertainties. There are
questions that time and future
research need to clarify. First,
we must understand that
although the completed clinical
trials show that immunised
people are protected against
developing disease and
dying, it is not established
that the protection is longlasting,
nor is it established
that immunised people
cannot have asymptomatic
infections and is incapable of
transmitting the virus to others.
The uncertainty regarding the
effect of vaccination on the
ability to transmit the virus is
a major scientific reason why
immunised people need to
continue wearing a mask and
follow social distancing.
Wearing a mask and socially
distancing seems like such a
small task in order to make
yourself and others keep safe.
Dr Peter Williams
Mumbai
Antibody overrun
Hi
The article on mRNA vaccines
is enlightening. The new
researches promote a new era
of more-efficient and easyto-make
vaccines. However,
a challenge governing all
vaccines is that they must
induce a scaled response
from the immune system
that is just enough so that
antibodies can guard against
future infection. If the response
is exceeded, too many weak
neutralising antibodies can
develop aiding for antibodydependent
enhancement
of the disease. This was
initially observed during
earlier outbreaks of MERS
and severe acute respiratory
syndrome coronavirus (SARS).
This has become a major
concern relating to the safe
administration of antibody
prophylaxis, antibody therapy
and antibody-based vaccines
against the ongoing COVID-19
pandemic. Individuals with
severe COVID-19 tend to
develop antibodies earlier than
those with mild disease.
Bindu Raghav
Thrissur
&
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news updates
UNION BUDGET 2021
INDIA HIKES HEALTHCARE
SPEND BY 137%
Allocates Rs 35,000 cr for COVID-19 vaccination
Union finance minister Nirmala
Sitaraman announced a total
additional spend of Rs 2.23 lakh
crore on “healthcare and well being” as
part of Union Budget 2021, including
Rs 35,000 crore for COVID-19 vaccine
development and inoculation.
This allocation is claimed to be a
137% increase from last year.
The key recommendations that
she spelt out in this additional
healthcare spend included an outlay
of Rs 64,180 crore over the next 6
years on healthcare infrastructure
development under a new centrally
sponsored scheme entitled Pradhan
Mantri Atmanirbhar Swasth Bharat
Yojana. This is aimed at increasing
capacities in primary, secondary
and tertiary care facilities, existing
healthcare research institutions and
setting up a new research institution
to detect new emerging diseases. The
other provisions are to strengthen and
set up health surveillance centres and
virology research institutes.
There was a mixed response from
the country’s healthcare industry and
professionals to the recommendations,
with the majority seeing in them some
much needed and keenly awaited
support.
“The Union Budget this year has
clearly announced the paradigm
shift in the way we look at health
and wellness in our country,” said
Cdr Navneet Bali, Regional Director,
Northern India, Narayana Health.
He added: “Setting up of
Nirmala Sitaraman
A BIG BOOST
The budget allocation for healthcare
more than doubled for FY 2021
₹94,452 cr
outlay for healthcare
a year ago
₹2,23,846 cr
earmarked for healthcare
and well-being
2020 2021
health and wellness centres in
rural and urban India, establishing
integrated public health labs and the
announcement of Rs 35,000 crore
towards vaccines are very important
and critical steps. Along with that,
thinking about clean air missions in
42 urban areas with a million plus
population, the setting up of critical
care hospital blocks in 602 districts
in India etc are again very important
steps which will strengthen the
country’s healthcare.”
According to Dr Anand Bansal,
Medical Director at Action Group
of Hospitals, this budget was
keenly awaited, especially for the
announcements in regard to the
health sector as the world has gone
through sudden and unprecedented
changes amid COVID-19 pandemic.
Also, the amount of Rs. 35,000 crores
announced for COVID-19 vaccination
will strengthen this fight against the
pandemic, he said.
This budget is satisfactory and
full of vision, he said. Considering the
challenges our healthcare sector is
facing, things will surely need time
to reflect results on a larger scale, he
added.
Meanwhile, Dr Prathap C Reddy,
Chairman, Apollo Hospitals Group said
this ground-breaking focus on health
will provide access to medical care
for all, fuel job creation and boost
economic momentum.
“India’s efforts at managing the
pandemic have been exemplary – our
8 / FUTURE MEDICINE / February 2021

frontline workers and scientists have
been working tirelessly to save lives
and develop indigenous vaccines. Now
the allocation of Rs. 35,000 crores for
COVID-19 vaccines and more if required,
makes our glorious nation stand tall as a
model for the world,” he added.
“The establishment of healthcare
infrastructure in the form of critical care
units and hospital blocks will also help
spur the growth of the domestic market
and place India as a key player in global
markets,” said Rajinish Menon, Founder
and CEO, Sukino Healthcare, India’s First
Continuum Care Provider.
Will help stall pandemic
The finance minister's commitment to
providing more funds in order to
contain the Coronavirus pandemic
spread in the country and provide
an effective, smooth path for
the vaccination scheme will help
contain, and lead our nation towards
accomplishing a COVID-19-free Bharat,
said Dr Krishna Ella, Chairman &
Managing Director, Bharat Biotech.
2021-22.
"The layout plan of a Rs. 64,180
crore spending plan for healthcare
over the next six years to be spent
on primary, secondary and tertiary
healthcare, in addition to the National
Health Mission is also a welcome move,
which will strengthen public health
services as 17,000 rural and 11,000
urban health and wellness centres and
integrated public health labs to be set
up in each district. The government
focus, on three areas - preventive
health, curative health and well-being, is
also very reassuring,” said Dr Ella.
With this landmark budget, the
government of India has signalled its
intention to make health a cornerstone
of the future success of our country. The
allocation to vaccines signals a shift to
preventive health care, a validation of
the fact that vaccines are the most costeffective
health care interventions, he
added.
Peritoneal dialysis to get
insurance cover
The Insurance Regulatory
Development Authority of India
(IRDAI) has released policy guidelines
to include peritoneal dialysis (PD)
within the ambit of private insurance
coverage.
According to the guidelines,
patients taking treatment of PD are
entitled to make reimbursement claims
on a monthly basis through
an approved pre-authorization
procedure.
IRDAI’s decision to include
peritoneal dialysis under insurance
policies will eliminate the exorbitant
expenditure associated with carrying
on dialysis at home.
Earlier, only haemodialysis
was covered by health insurance
policies but now, the latest revisions
in the health coverage are more
comprehensive and efficient for
policyholders.
JIPMER wins
Kayakalp award
for sanitation
and hygiene
T
he Jawaharlal Institute
of Postgraduate Medical
Education and Research
(JIPMER) has been awarded
the second prize under the
‘Kayakalp’ award scheme for
the year 2019-20 among
all the Group A Central
Government Health facilities
having more than 1,000 beds.
PD saves patients multiple clinic
visits and is generally more costeffective
and scalable as it can be
carried out at home and has lower
infrastructural requirements.
The provisions of the new
guidelines have been in effect from
October 1, 2020. According to Pradhan
Mantri National Dialysis Programme
(PMNDP), in India, 2.2 lakh people
who get affected by end-stage
kidney disease (ESKD) are on dialysis
or transplant for treatment. Dialysis
becomes the only option for patients
who are waiting for a transplant. There
is a demand of 3.4 crore dialysis per
year, with only 4,950 dialysis centres
approximately in India.
Despite PD’s potential advantages,
its penetration in the country is very
poor. According to a report, there were
just about 8,500 patients on PD in
India in 2019, reports said.
February 2021 / FUTURE MEDICINE / 9