Indians’ Psyche and COVID Pathogenesis

Recent concern of Prime Minister of India towards careless approach of Indian masses in general towards dealing current corona pandemic is worrisome. During lockdown due to coercive approach of the Government, exponential growth of the infection was warded off to a great extent. Since the day, ‘unlock down one’ was declared wef June1, 2020, the flagrant violation of Government’s guidelines is visible at every nook and corner. People are coming out without masks, flocking together unnecessarily, going on walk together without caring for physical distancing, children are playing in the parks and people are spitting around disregarding strict Government’s guidelines on the issue. Uttarakhand Government has even amended epidemic ordinance 1897 after Kerala and Odisha under which a penalty of Rs 1000 or maximum six month imprisonment can be imposed on any one defaulting by not wearing mask, violating quarantine norms or spitting in public places etc. Even then public seems to be sitting hunky dory in the absence of strict enforcement of the same. Government should evolve a mechanism for strict compliance of ordinances at least during emergency situations. For that purpose, institution building approach is need of the hour that makes everyone responsible from top to down in hierarchy for non-execution of orders.
The situation is so grim as the corona spread is taking its devilish shape with day to day increase in corona cases. It is happening because of all round indiscipline and ignorance towards gravity of situation. We should learn from the discipline of New Zealand that has become corona free because of political will and public cooperation. Leadership of Prime Minister Jascinda Ardern is also praise worthy who took timely decisions of imposing quarantine regulations and strengthening the health system that included comprehensive testing also. Another country that is playing a lead role in mitigating the pangs of corona pandemic is Vietnam that is under the leadership of President Nguyễn Phú Trọng, not only controlling through all round cooperation of one and all, it is also grabbing the opportunity of strengthening its economy by attracting the companies leaving China in resentment of spreading the pandemic world over. Vietnam lifted its social isolation norms at the end of April 22 but continues to take precautions by limiting the gathering of people and making face mask wearing mandatory. Vietnam has managed to achieve this feat by aggressive contact tracing, testing, mass quarantining, timeliness, and the efficient mobilization of state agencies.
Novel corona virus SARS-CoV-2 is a positive strand RNA corona virus of family coronaviridae which includes SARS-CoV and MERS-CoV viruses that caused earlier epidemics in Yunnan province China and middle- east regions respectively. Unlike other members of its family which affect lower respiratory tract (LRT), it is capable of affecting kidney, heart, retina and even brain besides LRT. It has largest genome of RNA viruses and has unique capability of hiding itself from immune response unlike other members of beta coronaviridae subfamily that were originated from bat. SARS-CoV-2 virus consists of four main structural proteins including spike (S) glycoprotein, small envelope (E) glycoprotein, membrane (M) glycoprotein, and nucleocapsid (N) protein, and also several accessory proteins. The spike or S glycoprotein is a transmembrane protein that facilitates binding of virus to host cells by attaching with angiotensin-converting enzyme 2 (ACE2) present in lower respiratory tract cells and extend upto epithelial region of nose, eyes and throat. Once attached to the ACE2 receptors in upper respiratory tract (URT) it shows its presence through the development of symptoms like high fever, dry cough, running nose, tiredness, tastelessness, odourlessness etc. But if it slips into LRT directly, COVID can take its severe form without showing any symptoms mentioned earlier and affects alveoli in lungs causing immune response in the form of cytokine storm leading to breathlessness needing ventilator support and in the severest form can lead to death due to multi organ failure.
We should understand the novelty of this virus to escape the immune system and affecting the LRT severely, one should be extra careful in dealing with the present scenario. Fellow countrymen must have been sensitized enough by now as the Government took all possible measures to do so. Increase in infected cases by leaps and bounds is the reflection of our wayward approach towards the pandemic. Corona cases till 18 June in India have become 367,264 causing 12,262 deaths. We are ignominiously sitting at fourth place after USA, Brazil and Russia and marching ahead rapidly day by day. This is the scenario when ICMR declares that we have not reached the community level yet. Once that happens, the number of infected cases will rise further. So every fellow Indians should take it as an awakening call and should maintain the patience they have shown earlier during lockdowns and abide by the Governments’ guidelines in letter and spirit to win war against the pandemic.

Dr Prashant Thapliyal
Assistant Professor
Army Cadet College
IMA Dehradun