CIVIL SNIPPETS

E-commerce firms can’t supply non-essential goods, says govt. #GS3 #Economy

The Ministry of Home Affairs (MHA) on Sunday clarified that supply of non-essential goods by e-
commerce companies will remain prohibited during the lockdown.

The Ministry also issued guidelines for the movement of migrant labourers living in relief camps to
their workplace, within the boundaries of a State, in areas where the lockdown will be relaxed from
April 20.

The Ministry asserted that there will be no inter-State movement of labourers. They will be registered,
screened and those who are asymptomatic would be transported to their places of work by ensuring
social distancing measures. The relaxations will not apply to hotspots or containment zones, and
public transport will remain prohibited till May 3.

On April 15, the MHA had revised its guidelines issued under the Disaster Management Act, 2005, to
allow the States to decide on the additional public activities to be allowed from April 20 in non-
hotspot zones. It said the additional facilities would have to be based on strict compliance with the
existing guidelines on lockdown measures.

As per the April 15 order, “e-commerce companies” and vehicles used by their operators had been
allowed but it was not specified if it was applicable to items others than essentials. On Sunday, the
MHA wrote to the States to exclude the e-commerce category from the revised guidelines.
In another letter, Union Home Secretary Ajay Bhalla clarified that e-commerce firms would continue to
operate for home delivery of essential goods, as earlier.

Commerce and Railway Minister Piyush Goyal tweeted that he was grateful to Prime Minister Narendra
Modi for the clarification that “e-commerce companies can only supply essential goods during the
lockdown”. “This will create a level playing field for small retailers,” he added.

The Confederation of All India Traders issued a statement claiming credit for the exclusion of e-
commerce companies.

https://www.thehindu.com/todays-paper/e-commerce-firms-cant-supply-non-essential-goods-says-
govt/article31384658.ece

Confusion over mismatch in Health Ministry, ICMR figures #GS3 #SnT

A day ahead of a possible relaxation in lockdown curbs, confusion reigned on the actual number of
COVID-19 cases in the country registered on Saturday.

The Indian Council of Medical Research (ICMR), which coordinates testing and is the central node of
data regarding the daily infections, reported that 16,365 individuals had been confirmed positive. Of
these 2,154 were confirmed on Saturday alone — the first time the daily case load breached the 2,000
mark.

However, the Health Ministry, the point-Ministry for all information regarding COVID-19, reported only
14,792 cases and 957 new cases.
On Sunday, the ICMR reported that 17,615 individuals have been confirmed positive. However, the
Ministry, which updates figures twice daily, continued to report the lagged figures. At the daily
afternoon briefing, Joint Secretary in the Health Ministry Lav Agarwal updated this to 15,712. By Sunday
evening, this had crept up to 16,115 but still fell short of the ICMR’s Saturday numbers.

https://www.thehindu.com/todays-paper/confusion-over-mismatch-in-health-ministry-icmr-
figures/article31384661.ece

PM-CARES donations cut from govt. staff salaries #GS3 #Economy

Employees from a number of government departments and agencies have donated a day’s salary
toward the PM-CARES fund.

While the donations, meant for COVID-19 relief, were said to be “voluntary”, government circulars
show that the deductions were made directly from salaries. Those unwilling to donate were asked to
submit their refusal in writing.

Revenue Dept. notice

On Friday, the Revenue Department in the Finance Ministry sent a circular to all officials, including those
on the boards for direct and indirect tax.

“It has been decided to appeal to all officers and staff to contribute their one day’s salary every month
till March 2021 to the Prime Minister's Citizen Assistance and Relief in Emergency Situation (PM-CARES)
Fund to aid the Government’s efforts to fight the coronavirus pandemic,” the circular read.

‘Objections in writing’

“Any officer or staff having objection to it [the donation] may intimate Drawing and Disbursing Officer
(DDO) in writing mentioning his/her employee code latest by 20.04.2020,” the circular added.

The communications come as a surprise to the officers and staff of the department as, they say, typically
requests for such contributions come through the employees’ association. Further, employees were
never asked to give it in writing if they did not want to donate.

https://www.thehindu.com/todays-paper/pm-cares-donations-cut-from-govt-staff-
salaries/article31384662.ece

Pharma units still not able to operate freely #GS3 #Economy

A week after the Department of Pharmaceuticals warned of an impending shortage of drugs if
pharmaceutical units are not able to operate freely during the lockdown, there has only been a marginal
improvement in their functioning, with employee movement, transport and raw material supplies still
hampered, and courier services remaining non-functional.
Most domestic pharmaceutical producers are operating at 30%-50% of capacity, while larger research-
driven players say they have hit 40%-50%.

On April 11, the Department of Pharmaceuticals told the Home Ministry that the industry was
operating at just 20%-30% of capacity and called for immediate measures to bring the output back to
the pre-lockdown level.

The Department is co-ordinating with the Ministry of Civil Aviation to bring in raw materials, finished
drugs and vaccines on special flights operated by Air India. The Department of Posts and the Railways
have offered pharma producers their services to help reach products to the hinterland.

“Manpower availability has improved a little, but people who have left the cities and gone back are hard
to replace. Materials movement hasn’t improved much and packaging also remains difficult to procure,”
said Daara Patel, secretary-general of the Indian Drug Manufacturers’ Association, which represents
over 1,000 large, small and medium companies.

https://www.thehindu.com/todays-paper/pharma-units-still-not-able-to-operate-
freely/article31384659.ece

Spare monkeys the virus, say biologists #GS3 #SnT

Feeding monkeys during the COVID-19 pandemic could have profoundly negative effects in the long-
term, such as helping the SARS-CoV-2 virus mutate and infect primates, biologists have said in a note,
advising caution.

Honnavalli M. Kumara, principal scientist at the Salim Ali Center for Ornithology and Natural History
(SACON), said it was well documented that viruses and endoparasites could transmit between humans
and primates.

“The worst-case scenario is that SARS-CoV-2 mutates and infects other primate species. This could
lead to many scenarios, such as the virus affecting the health of the affected animal populations or
the animals serving as reservoirs or hosts and spreading the disease to other species or human
populations,” another senior wildlife biologist from Tamil Nadu said.

“It is a matter of common sense to limit interaction between humans and wildlife, especially primates,”
he added. Feeding primates should be discouraged regardless of the pandemic, in order to prevent not
just the spread of diseases but also to minimise problematic human-primate interaction.

Ashni Dhawale, a researcher at the National Institute of Advanced Studies at Indian Institute of Science,
Bengaluru, who is studying ecology and behaviour of the endangered lion-tailed macaque, said primates
and humans share a complex relationship.

A ‘provocation’
Monkey troops accustomed to being fed by people could view denial of food as a “provocation,” leading
to hostile interactions. “Monkeys start associating humans with food, and when food is denied, can
attack them,” she said.

https://www.thehindu.com/todays-paper/spare-monkeys-the-virus-say-biologists/article31384665.ece

Lockdown cannot be the only strategy #GS3 #SnT

What do we know about COVID-19 and how far do you think we are to finding a cure?

Though it is a novel virus, virologists have been familiar with this group called coronavirus. This group
had caused outbreak of SARS in 2002 and MERS in 2009. It is less lethal than SARS but significantly
higher than influenza virus. Very lethal viruses, such as SARS, Ebola, cause limited infections because
they kill the people they infect and they do not get a chance to spread rapidly.

However, COVID-19 is highly infective; nearly twice that of influenza virus. That is why it is spreading
rapidly throughout the world. Most of the people dying of the infection are the elderly, people with
comorbidities and those whose immune system is suppressed.

Our record of finding cures to viral disease is not great. It is very difficult to find specific antiviral drugs
targeted to specific virus. Finding an antiviral to this virus is not going to happen easily. Currently various
antiviral drugs targeted for other virus like influenza are being tried out to treat COVID-19.

One of the reasons is that this virus changes rapidly and gives rise to variants. Already, we know that
there are multiple variants and a vaccine against one variant may not be effective against other.

As a virologist what do you think, after the lockdown will the spread of the disease be contained?

If you just do a mathematical modelling of how long it will take to stop the epidemic by doing just a
lockdown, I think it will be required till June or may be as far as September. In a lockdown you have
infected asymptomatic individuals who are staying in their homes and infecting people around them.

After the lockdown is lifted they will go out and infect more susceptible people, so there will be
resurgence. The question is whether is it feasible for us to keep extending the lockdown. We have seen
the pain that the lockdown has brought, especially to the poor.

The only way to stop this is to increase testing to such a level that we are able to identify and isolate
these asymptomatic infected individuals. This should be the aim of the lockdown period.

So the more the testing the better we are prepared to deal with the situation?

We have seen countries like Germany, Italy going up to 13,000 14,000 tests per million. In the U.S. the
number is 7,000 per million. I really don’t know if it is possible to achieve such numbers in India. We are
saying that there is a need to increase testing in places where you are seeing infections.
There is an urgent need to test asymptomatic people, people under quarantine or contacts of infected
people. Because of high infectivity of the virus the insistence on testing comes into play. If we are able
to test and isolate infected persons then we should be able break the chain of transmission.

There are concerns about the cost of the tests which comes to Rs. 4,500 per test. Can the price of test
be reduced?

ICMR has approved a specific test protocol for COVID-19 which is based on some kits. These kits are
nearly all imported and therefore there is dependency on them. Even using the kits, the pricing should
be substantially less. In fact, a cost estimate for a test comes to around Rs. 700. If we also explore
alternative methods which are regularly used in the labs the tests can be carried out at a cheaper cost.

It can be done by reagents which are cheaper. We do not know whether these have been explored
substantially. What we are suggesting is alternative testing should be encouraged and the dependence
on the imported kits should be reduced. In that way both the price of testing can be made more realistic
and more testing labs can be engaged.

There are talks about herd immunity? What are your views on it?

The way such viral transmission is stopped is by development of herd immunity. Herd immunity is when
a large section of the population develops immunity against the virus and thereby stops its further
spread. Herd immunity can only develop if people start developing antibodies against the virus. For that
certain level of interaction has to be there among the population.

So lockdown cannot be the only strategy ?

Lockdown should be part of a broad well planned comprehensive strategy. Lockdown is just one aspect
of the strategy. Other measures like enhanced testing, effective isolation of infected individuals,
monitoring of development of herd immunity should go hand in hand with lockdown as part of
comprehensive strategy to fight the COVID-19 outbreak.

https://www.thehindu.com/todays-paper/tp-national/tp-otherstates/lockdown-cannot-be-the-only-
strategy/article31384899.ece

PM calls for unity in COVID-19 response #GS2 #Governance

Prime Minister Narendra Modi on Sunday took to networking site LinkedIn to speak to young
professionals that adapting to new technology in the times of COVID-19 can help create new business
models and lead to the engagement of a large segment of Indians, including the poor, with technical
solutions.

“COVID-19 does not see race, religion, colour, caste, creed, language or border before striking. Our
response and conduct, therefore, should attach primacy to unity and brotherhood,” said Mr. Modi,
adding that this has to be so, since the virus has affected people across classes and communities.
The Prime Minister said that he too had been adapting to changes in his working style and professional
conduct. “Most meetings, be it with ministerial colleagues, officials and world leaders, are now via
video-conferencing,” Mr. Modi wrote on LinkedIn. The need of the hour is to think of business and
lifestyle models that are easily adaptable, he added.

“Doing so would mean that even in a time of crisis, our offices, businesses and commerce could get
moving faster, ensuring loss of life does not occur,” Mr Modi said. Today, the world is in pursuit of new
business models, he said, adding that India, a youthful nation known for its innovative zeal, can take the
lead in providing a new work culture.

The most “transformational impact” of technology, he said, often happens in the lives of the poor. “It is
technology that diminishes bureaucratic hierarchies, eliminated middlemen and accelerated welfare
measures,” he said giving the example of his own government’s push, since 2014, of Jan Dhan Yojana,
Direct Benefit Transfer (DBT) and Aadhar linkage.

“This seemingly simple connection has not only stopped corruption and rent-seeking, which had been
going on for decades, but also enabled the government to transfer money at the click of a button. India,
with the right blend of the physical and the virtual, can emerge as the global nerve centre of complex
modern multinational supply chains in the post COVID-19 world,” the Prime Minister said.

Logistics were only seen from the prism of roads and highways, but these two can be worked out from
the comfort of one’s home, Mr. Modi said. “Let us rise to that occasion and seize this opportunity,” he
said.

He stressed that efficiency, adaptability, inclusivity and universalism should be the watch words of the
“vowels of the new normal.”

https://www.thehindu.com/todays-paper/tp-national/pm-calls-for-unity-in-covid-19-
response/article31384582.ece

Pay cuts for PM-CARES leave staff uneasy #GS2 #Governance

A number of central ministries have given the nod for salary deductions of staff towards the PM-
CARES Fund. Defence Minister Rajnath Singh “approved a proposal” for the contribution of a day’s
salary to the fund from all Ministry employees, including Army, Navy, Air Force and Defence Public
Sector Units, according to an official statement issued days after the fund was launched.

The Ministry estimated a collective donation of Rs. 500 crore, but added that “the employees’
contribution is voluntary and those desirous of opting out will be exempted”.

‘Tough on families’

Responding to a circular issued on Friday by the Revenue Department of the Finance Minister that a
day’s salary will be deducted from all staff every month till March 2021, one joint secretary level official,
who did not want to be named, said, “No one actually asks. And one day per month for a year is 12 days.
That is 40% of a monthly salary... An average employee of the Government of India gets between Rs.
50,000 and Rs. 80,000 per month. That’s one salary and maybe three dependents. So it’s tough on
them,” the official said.

Earlier in the month, resident doctors from four government hospitals in the capital objected to the
automatic deduction from their salary of the donation, demanding that it be made an opt-in system, so
that only those who wished could choose to donate. Last week, both AIIMS and Safdarjung hospitals
agreed to the demand.

https://www.thehindu.com/todays-paper/tp-national/pay-cuts-for-pm-cares-leave-staff-
uneasy/article31384589.ece

‘If WHO has limitations, these have been imposed on it by nations’ #GS3 #SnT
#GS2 #IR

How unprecedented is the current challenge facing the WHO?

The WHO was established in 1948 and there hasn’t been a worldwide pandemic with this kind of
devastation that has come across its path. Something like this is calamitously challenging for the WHO.
And then you have the decision of the United States [on April 15] to withhold funding at this peak time.
The U.S. contributes something like 15% of the WHO budget. That is a pretty substantial sum of money
that is going to disappear from the WHO’s kitty. All of that adds to the challenges it is facing.

Is the U.S. criticism valid?

I really think Mr. Trump is honestly trying to find a scapegoat for his own administration failing in
preparing the U.S. sooner for what has turned out to be the biggest public health emergency they have
ever had. The fact is, if you look at what the WHO did or didn’t do, one can certainly accept the charge
that they were to willing to give China a free pass at the beginning of the crisis. I don’t think it’s easy to
blame the WHO for it.

One of the institutional challenges for any UN body is that it tends to be beholden to its most powerful
member states. I am afraid the problem is if this was something that started in the U.S., they would have
probably been deferential to the U.S. also. The difference is the U.S. being a democracy with a free
press, they would have not found it easy to suppress the kind of details that are only now emerging
from China.

Is it the case that WHO and most UN agencies are reliant on the information they receive from
member states?

We have a constitutional problem with all UN agencies that the head of the agency who is elected after
all with support of powerful member states, does not enjoy the independence and autonomy that
should come with a position of that stature. If we were, for example, to adopt a policy of a single, non-
renewable term for maybe six or seven years, rather than two terms of five which is normal practice,
then you might actually give a leader authority to take certain independent actions. Nonetheless, don’t
forget the UN is not larger or more powerful than its member states.

The principal fault is with Beijing and not the WHO, which is still a body that is dependent on member
states. India is a member of every UN body and every country knows how these bodies work. The
governments of the world actually want UN agencies to be beholden to governments, for the most part.

When they fail to assert enough independence and autonomy, the same governments start making
these agencies a scapegoat. When I was at the UN, my then boss [Secretary General] Kofi Annan would
often jokingly say about the initials SG by which we used to call him, ‘I know what that stands for –
scapegoat!’

On one hand, we are seeing countries turning inward. On the other, the pandemic is bringing an
awareness of the limitations of global institutions. Faced with two somewhat opposing impulses,
which way will we go?

The signs are indeed for a resurgence of national sovereignty. This suggests we will actually go in the
wrong direction and likely throw up more barriers. I believe that is the wrong way to go. India must play
a role in defying this impulse of closing countries off to the international community.

We have to recognise if the WHO had limitations, these are limitations that governments have imposed
upon it. If the world has to draw from this a conclusion that we actually need institutions of greater
independence in all our collective interest, then maybe we can reform these institutions, to give them
that independence. I hope a country like India will be a sane voice for this.

https://www.thehindu.com/todays-paper/tp-national/if-who-has-limitations-these-have-been-imposed-
on-it-by-nations/article31384603.ece

Goa is first to turn virus-free #GS3 #SnT

Goa on Sunday became the first zero COVID-19 State in the country with the last seven cases also
testing negative. This makes Goa the first green State in the country with no case of COVID-19 being
reported from April 3. The coastal State had a total of seven positive cases, of whom six had travel
history and one was the brother of a patient.

“Goa is now COVID-19-free, all seven patients have tested negative. They will be quarantined at
government facility and later at home,” Chief Minister Pramod Sawant said. Goa has in all tested over
800 people of whom seven had come positive.

Dr. Sawant said that though Goa was the first State to be free of any tested positive case and a happy
moment for everyone, especially the frontline workers, it was important to realise that this was no
time for complacence.
The Chief Minister said that from April 20, the government would scrutinise reports of its three-day
door-to-door citizens survey done last week and decide on testing people for COVID-19 wherever felt
necessary.

“We have to ensure that we remain a zero COVID-19 State. The lockdown will continue till the Central
government decides. Our borders with Maharashtra and Karnataka will continue to remain sealed.
Anyone entering the State under special circumstances will have to stay in a government quarantine
centre,” he said.

The Chief Minister said government offices would resume 100% work from Monday. “To ensure that we
continue to remain a green zone State, social distancing will have to be maintained. State transport
buses will ensure this while shifting government staff. Two-wheelers will have a single occupant and
1,000 thermal guns will be positioned at various places,” he said.

Dr. Sawant announced that subject to permissions from designated officers, industrial units and private
businesses would be allowed to start functioning.

Seafarers issue

On the issue of seafarers, the Chief Minister said the Centre would be announcing the repatriation
mechanism any time. “Once the government makes the mechanism official, it will take about 3-4 days
for the first lot of seafarers to return. Those already at Indian ports or closest to the coast will return
first. For the rest, discussions are on whether it would be the sea route or air route that would be taken
to get them back,” Dr. Sawant said.

All these seafarers would be subjected to quarantine followed by home quarantine, he said. Goa has
made available 8,000 rooms for Goan seafarers.

https://www.thehindu.com/todays-paper/tp-national/goa-is-first-to-turn-virus-
free/article31384605.ece

Islamophobia is rising in India: OIC #GS2 #IR

Calling on the Indian government to take steps to protect Muslim minorities who are being
“negatively profiled,” facing “discrimination and violence” amidst the COVID-19 crisis, the 57-member
Organisation of Islamic Cooperation (OIC) has criticised what it called “growing Islamophobia” in
India.

“[We] urge the Indian Govt to take urgent steps to stop the growing tide of Islamophobia in India and
protect the rights of its persecuted Muslim minority as per its obligations under international Human
Rights law,” said a tweet issued by OIC’s Independent Permanent Human Rights Commission (OIC-
IPHRC) on Sunday.

PM’s call for unity

The statement came on the same day Prime Minister Narendra Modi had clearly said that “unity and
brotherhood” must be the response to the coronavirus, which does not see “race, religion, colour, caste,
creed, language or borders before striking.”

The Ministry of External Affairs declined to comment on the statement.

Last week it had reacted sharply to two similar statements on religious “stigmatisation” of minorities in
India by the U.S. Commission on International Religious Freedom (USCIRF). In one statement, the U.S.
Commission criticised India, Pakistan and Cambodia for “failure to protect vulnerable religious
communities” and “increased stigmatisation”.

Patient ‘segregation’

In another specific statement, the USCIRF reacted to reports, which the government denied, that COVID-
19 patients were religiously segregated at a hospital in Ahmedabad.

On Saturday, it also held an expert hearing on “Religious Freedom on South Asia”, organised by the
“Hindus for Human Rights”, “Indian-American Muslim Council” and “International Christian Concern,”
ahead of its annual USCIRF report release on April 28, where India has been categorised as a “tier 2
country of particular concern.”

Misguided reports: MEA

“As if its peremptory commentary on religious freedom in India is not enough, the USCIRF is now
spreading misguided reports on the professional medical protocols followed to deal with spread of
COVID-19 in India,” the MEA spokesperson had said.

Meanwhile, on March 30, the United Nations’ Office of The Commissioner for Human Rights had issued
a more general statement against the “exploitation” of coronavirus-related fears by groups and
politicians to “scapegoat minorities” in various countries.

https://www.thehindu.com/todays-paper/tp-national/islamophobia-is-rising-in-india-
oic/article31384620.ece

Remdesivir: hope, with caution #GS3 #SnT

The drug remdesivir has been under the spotlight as a possible treatment for critical cases of
novel coronavirus disease (COVID-19). Globally, it is one of the four possible lines of treatment being
investigated in the Solidarity trials under the aegis of the World Health Organization (WHO). While the
drug is yet to get approval in any country to treat COVID-19, recent studies have claimed they have
found promising results.

What is remdesivir?
It is a drug with antiviral properties that was manufactured by US-based biotechnology company in
2014, to treat Ebola cases. It was also tried in patients of MERS and SARS, both caused by members of
the coronavirus family, but experts said it did now show promising results back then.

Coronaviruses have a single-strand RNA as their genetic material. When the novel coronavirus SARS-
CoV2 enters a human cell, an enzyme called RdRP helps the virus replicate. Remdesivir works by
inhibiting the activity of RdRP.

Infectious disease expert Dr Tanu Singhal said, “When the virus engulfs itself around a human cell, it
injects its RNA inside the cell. The RdRp enzyme causes viral replication. Remdesivir inhibits the enzyme
and stops further replication.”

What have studies found?

A small cohort study published in The New England Journal of Medicine on April 10 used remdesivir on
61 patients in USA, Canada, Europe and Japan. These patients were critically ill with low oxygen levels,
and were administered remdesivir under manufacturer Gilead’s compassionate use programme. Each
patient was administered a 10-day course of remdesivir — 200 mg on the first day and 100 mg each on
the other nine days. Of them, 53 patients were studied.

The study found clinical improvement in 68% of the cases, with their oxygen levels improving; 47%
patients could be discharged after treatment, and more than 50% patients (17 of 30) no longer required
mechanical ventilator support. The study found that clinical improvement was less frequent in patients
on invasive ventilators or among elderly people. Seven patients died despite treatment with remdesivir.

Another study, published on April 13 in the Journal of Biological Chemistry by researchers from the
University of Alberta, reported promising results but not in patients. The researchers conducted a
laboratory study in which the drug was able to prevent the virus from replicating.

The lab study also targeted the enzyme that drives the virus’s replication in the body. Matthias Götte,
chair of medical microbiology and immunology at the University of Alberta, said that remdesivir tricks
the virus by mimicking its building blocks. “These coronavirus polymerases (RdRP enzymes described
above) are sloppy and they get fooled, so the inhibitor gets incorporated many times and the virus can
no longer replicate,” Götte said in a statement.

How promising are these results?

No study on remdesivir so far has been large enough to be viewed with credibility. The study published
in The New England Journal of Medicine looked at 53 patients, who represent too small a cohort to draw
definitive conclusions. Also, 13% of the patients in the study died.

The study had no control arm, meaning another group of patients who were not administered the drug,
to compare outcomes of treatment with and without remdesivir. Unless such trials are conducted, the
effect of the drug remains a grey zone.
The study’s lead author, Jonathan D Grein, director of hospital epidemiology, Cedars-Sinai Medical
Center, Los Angeles, said “no definitive conclusions can be drawn from these data” but he encouraged
further controlled trials to validate the treatment potential of remdesivir.

Dr Harshad Limaye of the internal medicine department in Mumbai’s Nanavati Hospital, a designated
COVID-19 hospital, said remdesivir did not show great results with Ebola either. “But the Ebola and
coronavirus are different. We should wait for the trials to measure the efficacy of the drug for COVID-
19,” Dr Limaye said.

What is India’s stand on remdesivir?

The Indian Council of Medical Research (ICMR) has said it can consider using the drug if local
manufacturers are willing to procure it. Remdesivir is currently not available in India. The ICMR plans to
wait and watch for the results of WHO’s Solidarity trials to make an assessment on the efficacy of
remdesivir for COVID-19 treatment.

Where else in remdesivir being studied?

Currently, there are about six trials and studies being done globally for remdesivir. China has initiated
two clinical trials using remdesivir in multiple sites in Hubei province, the worst hit with COVID-19. One
study will focus on critically ill patients with low oxygen levels. The other study will focus on patients
with moderate symptoms.

In the US, the National Institutes of Health has started a phase-II randomised placebo-controlled trial for
adult patients. In France, the INSERM research institute is conducting a study to evaluate potential
treatments for COVID-19; these include remdesivir.

Gilead is also running a phase-III trial in the US, Asia and Europe.

What are the other lines of treatment being investigated?

Hydroxychloroquine, an anti-malarial drug, is undergoing multiple trials to assess if it can be used to

treat severe COVID-19 cases. It works by decreasing the acidity in parts of the cell where the virus is
present, thereby inhibiting it.

Again, ritonavir and lopinavir are two antiviral drugs used for treatment of HIV. These too work by
inhibiting the virus;s RNA. Specifically, they target the enzyme that helps the virus split proteins.

These two drugs are being used in India and several countries for seriously ill patients. In HIV patients,
these two antiviral drugs work together to decrease the viral load in blood. Their use in COVID-19
patients seeks the same outcome. “But so far, it has not shown great success in viral suppression,” said
Dr Pravin Amle, infectious disease expert. He relies on the antibiotic azithromycin as his first choice.

In Wuhan, a clinical trial on 199 patients published in The New England Journal of Medicine on March 18
did not find a clinical difference between patients given ritonavir-lopinavir and those not given the
combination.
https://indianexpress.com/article/explained/remdesivir-drug-coronavirus-covid-19-india-cases-death-
toll-6370010/

How pooled testing works, when it helps #GS3 #SnT

Faced with criticism about insufficient testing and the reality of limited resources, India has decided go
for pooled testing in districts where no cases have been reported. This would on the one hand give data
on whether these really are zero-case districts, and on the other, save resources.

What is pooled testing?

It is a method of testing several samples together with the same technique (RT-PCR) that is being
currently used to test individual samples. Samples taken from the nose or throat are pooled together by
suspending them in a solution in laid-down proportions. The remaining samples are then labelled and
kept separate. Pooled samples are subjected to a test; if it is negative then all samples in the pool are
cleared. If it is not, then individual samples are tested to find out which one is positive.

What does the Indian Council of Medical Research say on pooled testing?

Last week, the ICMR brought out an advisory on pooled testing, ideally in districts where incidence of
COVID-19 is low.

“Number of COVID-19 cases in India is rising exponentially. In view of this, it is critical to increase the
numbers of tests conducted by laboratories… Hence, it may help to use the pooled samples for
screening… As all individual samples in a negative pool are regarded as negative, it results in substantial
cost savings when a large proportion of pools tests negative,” the advisory said. The idea, it said, is to
increase the capacity of laboratories to screen more samples for surveillance rather than diagnostic
purposes.

The advisory followed a feasibility study at the Virus Research & Diagnostic Laboratory at King George’s
Medical University, Lucknow. The study showed that “performing real-time PCR for COVID-19 by pooling
5 samples of TS/NS (200 microlitres/sample) is feasible when the prevalence rates of infection are low.”

The ICMR has also set an upper limit of five samples that can be pooled; this is to avoid false negatives
because of excessive dilution. More samples can, however, be pooled if it is being done only for
research purposes.

Last week, the ICMR brought out an advisory on pooled testing, ideally in districts where incidence of
COVID-19 is low.

Where can pooled testing take place?

The ICMR document is clear that pooled testing is only to be used in “areas with low prevalence of
COVID-19 (initially using proxy of low positivity of <2% from the existing data). Still a watch should be
kept on increasing positivity in such areas”.
It adds: “In areas with positivity of 2-5%, sample pooling for PCR screening may be considered only in
community survey or surveillance among asymptomatic individuals, strictly excluding pooling samples of
individuals with known contact with confirmed cases, Health Care Workers (in direct contact with care
of COVID-19 patients). Sample from such individuals should be directly tested without pooling.” The
ICMR does not recommend pooling in areas where positivity rates exceed 5%.

Government sources, though, say pooled testing is currently being considered only in the districts from
where no cases of COVID-19 have been reported so far. Reacting last week to reports of private
hospitals resorting to pooled testing, Dr R R Gangakhedkar, head of epidemiology and infectious
diseases at ICMR, said: “This is to be done in areas where the rate of seropositivity is less than 2%… five
samples can be pooled. This helps clear more people with less tests. So far private hospitals are
concerned, this is not exactly for individual diagnosis. Using it like that should affect the testing charges.
Private hospitals should think about this.”

Is pooled testing being used elsewhere?

In the US, pooled testing is being used in some areas to test population-level infection rates. For
example, scientists from Stanford Medicine used it to estimate the prevalence of the disease in the San
Francisco Bay Area while conserving scarce testing resources.

It can be used for any disease whose test involves, like COVID 2019, an RT-PCR test, and is routinely used
for HIV screening purposes. In a 2010 article in The Journal of Acute Immunideficiency Syndrome, US
researchers noted: “Pooling strategies have been used to reduce the costs of polymerase chain reaction-
based screening for acute HIV infection in populations in which the prevalence of acute infection is low
(less than 1%). Only limited research has been done for conditions in which the prevalence of screening
positivity is higher (greater than 1%).” It is a well-recognised “screening tool” for epidemiologists.

https://indianexpress.com/article/explained/coronavirus-infection-how-pooled-testing-works-when-it-
helps-6370001/

How reverse repo rate became benchmark interest rate in the economy #GS3
#Economy
The Indian economy’s slowdown during 2018 and 2019 is becoming much worse in 2020 with the spread
of COVID-19 and the stalling of almost all economic activity. Like most other central banks in the world,
the Reserve Bank of India, too, has tried to cut interest rates to boost the economy. However, unlike in
the past, when the RBI used its repo rate as the main instrument to tweak the interest rates, today, it is
the reverse repo rate that is effectively setting the benchmark.

What are repo and reverse repo rates?

The repo rate is the rate at which the RBI lends money to the banking system (or banks) for short
durations. The reverse repo rate is the rate at which banks can park their money with the RBI.
With both kinds of repo, which is short for repurchase agreement, transactions happen via bonds — one
party sells bonds to the other with the promise to buy them back (or repurchase them) at a later
specified date.

In a growing economy, commercial banks need funds to lend to businesses. One source of funds for such
lending is the money they receive from common people who maintain savings deposits with the banks.
Repo is another option.

Under normal circumstances, that is when the economy is growing, the repo rate is the benchmark
interest rate in the economy because it is the lowest rate of interest at which funds can be borrowed
and, as such, it forms the floor rate for all other interest rates in the economy — for instance, the
interest rate consumers would have to pay on a car loan or the interest rate they will earn from a fixed
deposit etc.

What has changed now?

Over the last couple of years, India’s economic growth has decelerated sharply. This has happened for a
variety of reasons and has essentially manifested in lower consumer demand. In response, businesses
have held back from making fresh investments and, as such, do not ask for as many new loans.

Add to this, the pre-existing incidence of high non-performing assets (NPAs) within the banking system.
Thus, the banks’ demand for fresh funds from the RBI has also diminished. This whole cycle has acutely
intensified with the ongoing lockdown.

As such, the banking system is now flush with liquidity for two broad reasons: on the one hand, the RBI
is cutting repo rates and other policy variables like the Cash Reserve Ratio to release additional and
cheaper funds into the banking system so that banks could lend and yet, on the other, banks are not
lending to businesses, partly because banks are too risk-averse to lend and partly because the overall
demand from the businesses has also come down.
So, how has reverse repo become the benchmark rate?

The excess liquidity in the banking system has meant that during March and the first half of April, banks
have been using only the reverse repo (to park funds with the RBI) instead of the repo (to borrow
funds). As of April 15, RBI had close to Rs 7 lakh crore of banks’ money parked with it. In other words,
the reverse repo rate has become the most influential rate in the economy.

What has the RBI done?

Recognising this, the central bank has cut the reverse repo rate more than the repo (see graph) twice in
the spate of the last three weeks. The idea is to make it less attractive for banks to do nothing with their
funds because their doing so hurts the economy and starves the businesses that genuinely need funds.

Will the move to cut reverse repo work?

It all depends on the revival of consumer demand in India. If the disruptions induced by the outbreak of
novel coronavirus disease continue for a long time, consumer demand, which was already quite weak, is
likely to stay muted and businesses would feel no need to borrow heavily to make fresh investments. If
consumer demand revives quickly, the demand for credit will build up as well.

From the banks’ perspective, it is also important for them to be confident about new loans not turning
into NPAs, and adding to their already high levels of bad loans. Until banks feel confident about the
prospects of an economic turnaround, cuts in reverse repo rates may have little impact.

https://indianexpress.com/article/explained/coronavirus-rbi-how-reverse-repo-rate-became-
benchmark-interest-rate-in-the-economy-6369999/