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FUTUREMEDICINEINDIA.COM
COVID-19 &
NEANDERTAL DNA
DISEASE SEVERITY LINKED TO GENES INHERITED FROM OUR ARCHIVAL RELATIVES
RESEARCH SPECIAL REPORT POLICY FM COVID-19 UPDATES
EMERGING TRENDS
IN AT-HOME
COVID-19 TESTS
COVID-19: SECOND
WAVE ROCKS INDIA
INDIAN MEDICAL
SERVICE
ON ITS WAY?
FIVE INDIAN FIRMS
MAKE SPUTNIK V VAC

editor’s note
April 2021 / Vol. 7 / Issue 12
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
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CH Unnikrishnan
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editor’s note
Dear Doctor,
editor’s You will remember note the prediction we made in our last edition that the
fast-spreading
editor’s note
mutant variants of SARS CoV-2 will dominate the second
and Dear third Doctor, waves of COVID-19, with potential for immune escape of the virus.
Barely Dear Doctor, a few days later, India has officially started tallying the damage from
My daughter, like every other urban, school-going child, had hardly any time to
the Perhaps second against wave, most with of its our most expectations, striking feature we still find being ourselves the rapid in the spread.
sit unengaged. Besides endless academic chores, including the hectic homework middle of
India a raging is now pandemic. home Like to most everyone of the else, mutant you too variants are exhausted from with across all the options globe,
and soft skill projects and presentations, she also found time for her painting and
including for disease those management from the laid UK, out Brazil before and you. South However, Africa, the fact along is that with symptom a more
dancing classes. In between all these edu-arta-thons, she would also invariably
serious relievers double
Dear and Doctor proven mutant. and unproven On 27th immunity March — boosters the day are this the issue only went options to in press,
squeeze in her favourite sports and workouts with school and building buddies,
front
the of the country infected, recorded and that more the pandemic than 62,000 remains positive as untamed cases as — ever. more All than hope double
of whom she has many. But, COVID-19 has put a stop to all that. The lack of
now
the
the rests
usual
count on
We opportunities
a potential a week earlier. vaccine.
know you are for busy. action,
Note But
It is with
how the
always classes
close difference: are
reassuring confined
we to In that the
that to the
panacea first
trust internet
wave, really?
and and,
it had Not
faith most
taken very,
of of all,
23 to be frank, but not very far either.
the
days
hundreds relentless
for the
of confinement
country to
patients in at
move
your home,
from
healing often
30,000
touch leaves keeps her
cases
moody
a day
you busy and
to
in glum—a
60,000,
this noble typical
despite Indeed, the latest WHO survey has a list of 165 SAR-CoV-2 vaccine candidates
psychological
the fact
profession. syndrome
that there
under development In the across hectic that
were
the practice, affects
far
the
greater
world. At it’s ‘normal’
numbers
least quite 23 natural people
of them that exposed
of susceptible
are you in clinical might to ‘abnormal’
people
trials miss
who and
situations. could
six are out in on This have
final some pandemic been infected.
stages, of the including latest and developments the And, prolonged predicted
phase-3 human in lockdown by
studies. emerging is epidemiologists,
nothing
Eight medicine. less
vaccine candidates In than this era a very
the ‘abnormal spread
are in of various innovation,
situation’ of the epidemic
stages medical
for not
of development science
just then her, started
is
but getting
millions slowing
India too. redefined
of children down
Of these, almost
and after
two by
adults infecting
are the already day.
across a
Old
the
critical world. proportion of the population. This was due to the corresponding
reduction 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 repercussions in the number and manifestations of uninfected of people this prolonged who can abnormality potentially in get our
infected.
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
while been
life Therefore, vary
genomics allowed
from
to
person the key
and be tested
to point person. that
molecular in India.
These we
science The unveil Indian
include raised
the manufacturing
anxiety in our cover and depression story last
mysteries of partner life further. of
as time
becomes
the
well
We British
as biological all the more
are vaccine
effects relevant:
fortunate project—Serum
like disturbed Can
to have such Institute
sleep, the mutant
breakthroughs of India
appetite variants
— as will
disturbances cause
they conduct help specialists the
and re-infection?
observerblind,
other
The like
emotional second
you
randomised
difficulties. question
rise above
controlled
The we severity raised —
the expectations
study
may are
to
of
determine
even some extend of the
today’s informed
the safety
to mental new variants
patient.
and immunogenicity
illness and vaccineresistant?
even
of substance —
the vaccine misuse. too has
candidate The become young in about and critical.
1600 the old, If yes,
healthy pregnant we have
human women, no time
volunteers family to
in the members waste:
country. of
The
However, the infected genetic
this and mapping
is only those the
of who second
the have mutated
phase died of due virus
human to the needs
trials, infection to
and
be
they and expedited
will even move the and
to lonely the
vaccines
Phase-3 are Similarly, all vulnerable only
should it
when
is also be to the mental tested a
company
time health against when
is successful issues India the is mutant caused witnessing
in submitting by variants. the revolutionary pandemic safety data, and growth
evaluated society’s in
by reaction However, the healthcare Data to it. Safety all industry, hope Monitoring is especially not lost. Board New in (DSMB), the research private to the sector, has CDSCO—the found wherein that Indian many increasing drugs of us
have regulator. One number innate of the of immunity most doctors crucial are against areas taking we severe up must multiple SARS focus roles CoV-2 on is of the infection. clinician, psychological researcher A new impact study and that
using this These entrepreneur. has data on promising from the first the This advancements response Genetics requires teams expansion of by Mortality like the you scientific of and your in Critical your community focus colleagues. Care to a wider worldwide (GenOMICC) The canvas. long are In hours
consortium certainly spent this working context, commendable. showed in it potentially becomes that But, a important dangerous what haplotype we seem how and on to a chromosome unpleasant busy be losing professional sight situations, 12 that in like all such some you this as can are of testing the
us very labs, inherited keep real hospital challenges pace from wards with one these and of risks COVID latest our involved extinct ICUs, developments makes in relatives vaccine frontline development. — a quick the health Neandertals workers The easy development
way. prone — is to such
associated of mental a safe health vaccine with issues. at typically least In this a a 22% edition, long, reduction complex we wanted process in the to highlight and risk often becoming the lasts ground 10-15 severely realities years
ill and on when this
At involves Future
front infected multiple and
Medicine,
the by elements paramount the which virus. is of This conceived
importance research haplotype and and
of development providing
crafted is present by
additional
a and at team substantial various of
mental
senior levels health
frequencies 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, scientists all regions and of doctors, the world our outside aim is to Africa. help you The do genomic just that. region We
where process Another 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
this
equipped
haplotype
to bring
occurs
you the
encodes
latest from
proteins
the science
that are
of
important
care from across
during
infections urgently. South Asian That, by population—uncovering RNA however, viruses. doesn’t Our answer cover the the story question takes behind of a deep whether first-ever dive such into Genome-wide
a rapidly this new
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
finding.
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 talks
about
Wishing Also specialised the in this you
greater edition an knowledge insightful
impact is a special that vehicle reading,
it feature can that make plugs on the in India, you latest into scientific Straight the emerging advancements Talk of world this edition. of
a most care promising seamlessly. cardiovascular Come, let’s 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
editor@futuremedicineindia.com
C H Unnikrishnan
editor@futuremedicineindia.com
C H Unnikrishnan
editor@futuremedicineindia.com
www.futuremedicineindia.com futuremedicineindia FutureMedIndia
AUGUST 2018/ FUTURE MEDICINE / 3

RESEARCH SPECIAL REPORT POLICY FM COVID-19 UPDATES
Vol 7 Issue 12
April 2021
₹ 250.00
VOL 7 | ISSUE 12
PAGES 100
APrIL 2021
FUTUrEMEDICINEINDIA.COM
DISEASE SEVERITY LINKED TO GENES INHERITED FROM OUR ARCHIVAL RELATIVES
EMERGING TRENDS
IN AT-HOME
COVID-19 TESTS
COVID-19 &
NEANDERTAL DNA
COVID-19: SECOND
WAVE ROCKS INDIA
INDIAN MEDICAL
SERVICE
ON ITS WAY?
FIVE INDIAN FIRMS
MAKE SPUTNIK V VAC
REGULAR FEATURES
06 Letters
08 News updates
18 Policy
36 Drug approvals
43 Hospital news
46 Research snippets
64 Diagnostics
70 Devices&gadgets
74 Gynecology &
paediatrics
76 Disease
78 Drug safety
80 Public health
84 Guidelines
96 Calendar
98 Holy grail
Columns
23 TRIALOMICS
Dr Arun Bhatt
50 THE CELLVIEW
Dr Rajani Kanth Vangala
12
SPECIAL REPORT
SECOND SURGE
OF COVID-19
ROCKS INDIA
Experts divided on linking the
current spike in cases to the rise
of new variants of SARS-CoV-2
20
RESEARCH
NEEDED:
AT-HOME COVID-19
DETECTION TESTS
With the second wave of COVID-19
on its way, should India allow home
testing for the infection?
44
STRAIGHT TALK
“BIOBANKS
HAVE ENABLED
HEALTHCARE
INNOVATION”
Dr Jugnu Jain
Co-founder,
Sapien Biosciences

52
FM COVID-19 UPDATES
UK COMMITS
£7 BN FOR
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24
COVER STORY
NEADERTAL
BEHIND
CRITICAL
COVID?
DNA from the ancestral hominins
comes under the lens as
researchers seek to unravel the
mystery of SARS-CoV-2 illness
turning deadly in some people
66
INDUSTRY
HOW SAFE
ARE OUR
MEDICAL
DISPOSABLES
The quality of medical
disposables and devices
continues to be a concern
in India as there are no
stipulated norms to assure it
The biggest risk
factor for getting
severely ill upon
infection with
SARS-CoV-2
comes from
Neandertals.
Svante Pääbo
Director, Max Planck
Institute for
Evolutionary
Anthropology, Leipzig

IN THE NEWS RESEARCH DRUG DELIVERY COVID-19 UPDATES
letters to the editor
‘MIXOPATHY’: IMA
ON THE WARPATH
VARIANTS
vs VACCINE
ThE MUch hOPED-FOr cOVID-19 VAccINES STUMBLE
AS SArS-coV-2 MUTATES FASTEr ThAN EXPEcTED
FIGHTING COVID-19
INTRANASALLY
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FOUR THERAPEUTICS
ENTER PHASE 2/3
A more dangerous
wave?
Dear Sir,
After a downturn, India has
recently started to encounter a
disturbing rise in new COVID-19
cases, with newer variants
now referred to as the "double
mutant" strain. Epidemiologists
said the term double mutant
refers to a new variant that
has the characteristics of two
already identified variants. The
variant, described by officials
has been found in more than
200 samples in the hardest-hit
western state of Maharashtra.
But the health officials say
that the new variant has not
been detected in large enough
numbers to link it to the surge
in cases in Maharashtra and
other states including Kerala
and Punjab. The variant has
been detected in several
Indian states, triggering fear
that India’s “second wave”
could be more dangerous
than the first. Additionally,
authorities have reported
several other variants in at
least 18 states amid a surge in
coronavirus infections across
the country which include
those from UK, Brazil and
South Africa. However, because
there is no evidence that these
variants are more transmissible
or more lethal than what we
already have, this leaves us
thinking if there is a reason to
be worried about this particular
variant.
Dr Navneeth P
Banglore
Keep up all precautions
Hi
After a year of surviving amidst
the COVID-19 pandemic and
having it take over almost
every aspect of personal and
professional life, many just
want their normal lives back.
Even though there are many
hesitancies around COVID
vaccination, nowadays, people
seem to be more willing to
take them so they can be
protected and free. We must
get vaccinated as soon as we
can, but we cannot rely on
that. What many might ignore
is about continuing to stick to
the protocols during and after
vaccination. Many people had
already started to forget about
the pandemic or got used to it
when all of a sudden the cases
started to increase recently.
My hunch is that it is the case
across the country. Although
vaccination has been initiated
and people are starting to
come forward to take them,
there is still considerable
work to be done. I suggest
that we must take personal
responsibility to not ignore the
truth about this virus and keep
up the precautions.
Lavina D
Mumbai
&
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news updates
New MTP bill aims to expand
access to abortion services
The upper house of the
Indian parliament,
Rajya Sabha, has approved
the Medical Termination of
Pregnancy (Amendment)
Bill, 2021 that enhances
the upper gestation limit
from 20 to 24 weeks for
special categories of
women.
The bill, which seeks
to amend the Medical
Termination of Pregnancy Act,
1971, was earlier approved in
Lok Sabha.
The new bill aims to
expand access to safe and
legal abortion services
on therapeutic, eugenic,
humanitarian or social
grounds.
The amendments include
the substitution of certain
sub-sections and the insertion
of certain new clauses
under some sections in the
existing Medical Termination
of Pregnancy Act, 1971
with a view to increase the
upper gestation limit for the
termination of pregnancy
under certain conditions and
to strengthen the access
to comprehensive abortion
care, under strict conditions,
without compromising the
service and quality of safe
abortion.
Recently several petitions
were moved in the courts
seeking permission for
aborting pregnancies at a
gestational age beyond the
present permissible limit
on the grounds of foetal
abnormalities or pregnancies
due to sexual violence faced
by women.
The amendments will
increase the ambit and
access of women to safe
abortion services and will
ensure dignity, autonomy,
confidentiality and justice
for women who need to
24
months is the enhanced
upper gestation limit for
aborting the foetus for
special categories of women
terminate pregnancy.
The features of the
amendments include
enhancing the upper
gestational limit from 20
to 24 weeks for special
categories of women which
will be defined in the
amendments to the MTP
Rules and would include
survivors of rape, victims of
incest and other vulnerable
women (like differently-abled
women, minors) etc.
According to the new
bill, the opinion of only one
provider will be required up to
20 weeks of gestation and of
two providers for termination
of pregnancy of 20-24 weeks
of gestation. The upper
gestation limit will not apply
in cases of substantial foetal
abnormalities diagnosed by
the medical board.
8 / FUTURE MEDICINE / April 2021

Dr Harsh Vardhan
Dr Harsh Vardhan
to chair Stop
TB Partnership
board
In recognition of his
contribution to the movement
to eradicate tuberculosis (TB)
from India by 2025, Dr Harsh
Vardhan, union minister for
health and family welfare has
been appointed chairman of
the Stop TB Partnership Board.
The union health minister
will serve a three-year term,
commencing July 2021, as the
chair of the board of Stop TB
Partnership.
India has committed to
eliminating TB in the country
by 2025, five years ahead of
the global deadline of 2030.
The government of India’s
National Strategic Plan for TB
Elimination 2017-2025 outlines
an ambitious agenda and
targets which exceed even the
aspirational ones set by the
World Health Organization’s
(WHO) End TB Strategy for the
world.
This has attracted the
attention of members of the
organization who want to learn
and benefit from the medical
advancements and practices
to eliminate the disease as is
being implemented through a
National Strategic Plan in India.
In September 2019, Dr
Harsh Vardhan, had launched a
new and aggressive ‘TB Harega
Desh Jeetega’ Campaign, along
with the National TB Prevalence
Survey. Since then, multistakeholder
and community
participation has formed
the pivot of the countrywide
campaign. Patient forums have
been established in over 95
percent of all districts within
the first 100 days of the launch
of the campaign.
Established in the year
2000, the ‘Stop TB Partnership’
is mandated to eliminate
tuberculosis as a public health
problem.
The Stop TB Partnership
through the Amsterdam
Declaration gave a call for
collaborative action from
ministerial delegations from
20 countries that bear the
highest burden of TB. It has
1,500 partner organizations
which include international,
non-governmental and
governmental organizations
and patient groups.
IPC asks
regulators
to remove
lorcaserin
monographs
The Indian Pharmacopoeia
Commission (IPC), which
sets standards for drugs,
has issued notices to the
Drug Controller General of
India (DCGI), State Licensing
Authorities (SLAs), government
analysts and drug testing
laboratories directing them to
omit monographs of lorcaserin
hydrochloride hemihydrate
and lorcaserin tablets from the
Indian Pharmacopoeia (IP).
IPC has urged all
stakeholders in the country to
bring the same to the notice
Ayushman Bharat HWCs: India
meets 70,000 target
Union health ministry
stated that India
marked a key milestone in
universalizing primary health
care as planned target of
operationalizing 70,000
Ayushman Bharat- Health
and Wellness Centres (AB-
HWCs) by 31st March, 2021
has been realised ahead of
time.
The AB-HWC scheme
was launched in April
2018. By December 2022,
1,50,000 sub-health
centres and primary health
centres in urban and rural
areas were targeted to be
transformed to AB-HWCs
and deliver comprehensive
primary health care that
includes preventive and
health promotion at the
community level with a
continuum of care and
which is universal, free and
close to the community in
rural and urban areas, with
focus also on wellness. This
mission mode approach also
aimed at realising India’s
vision of Universal Health
Coverage.
HWCs demonstrate a
high potential for positive
outcomes in terms of
gender equity for careseeking
and promoting
wellness as a critical
component of primary
health care. To date, about
41.35 crore people have
accessed care in these AB-
HWCs. About 54% of them
are women.
The ministry stated
that HWCs also focus
on wellness and healthy
lifestyles through
various activities. So
far, these centres have
conducted 64.4 lakhs
wellness sessions.
During the COVID-19
pandemic, AB-HWCs
played a significant role in
undertaking public health
action related to COVID-19
prevention and enabling
non-COVID-19 essential
health services. About 75%
of total NCD screenings have
been conducted during this
COVID-19 period (between
1st February, 2020 and
mid-March) itself, showing
the confidence reposed by
people in these AB-HWCs
during the present public
health challenge.
“More than 60% of
team leaders (CHOs and
medical officers) and more
than 90% of field workers
of HWC teams are women.
This is a testimony to a
gender-sensitive approach
to healthcare. Community
ownership and community
management of these
centres envisaged through
the institutional mechanism
of Jan Arogya Samitis
(JASs) are being formed at
all functional AB-HWCs to
enable accountability of the
health care teams,” ministry
said.
April 2021 / FUTURE MEDICINE / 9