📰 COVID-19 Trials | In solidarity with recovery
Clinical trials of WHO and the U.K. are leading scientific efforts against the virus
•It is only appropriate that any pandemic the size of COVID-19 is matched by almost equivalent human effort to counter it. A range of treatments have been proposed, but only extensive population based-trials will provide evidence on their safety and efficacy. The need to fast-track development of drugs and a vaccine, and subsequently, the necessity to scale up manufacturing processes have naturally spurred vast, global efforts involving a large number of people, and in one instance, many nations.
•The World Health Organisation’s (WHO) Solidarity Trial and the U.K.’s RECOVERY Trial are two of the world’s leading scientific efforts pivoting cutting edge research in the battle against COVID-19. These past weeks have brought these two trials into the limelight, the latest being the study by the RECOVERY Trial that showed success in reducing mortality with low doses of a steroid — dexamethasone — to target lung inflammation.
•WHO Director General Tedros Adhanom Ghebreyesus explained the rationale of the Solidarity Trial: “The pressure COVID-19 puts on health systems means that WHO considered the need for speed and scale in the trial. While randomised clinical trials normally take years to design and conduct, the Solidarity Trial will reduce the time taken by 80%.”
•It started out to compare four treatment options against standard of care, to assess their relative effectiveness against COVID-19: Hydroxycloroquine (HCQ), Remdesivir; Lopinavir with Ritonavir; and Lopinavir with Ritonavir plus Interferon beta-1a. On June 17, however, the WHO announced that the HCQ arm of the Solidarity Trial was being stopped. The decision was based on evidence from the Solidarity Trial, the RECOVERY Trial and a Cochrane review of other evidence on HCQ. Data showed that HCQ dId not result in the reduction of mortality of hospitalised COVID-19 patients.
•While it came with its own controversy over the validity of data sets used in papers published in two peer-reviewed journals, as the clouds cleared, ultimately the generation of conclusive evidence to suspend HCQ is proof of concept. In the process of moving towards the end point of COVID-19, it is also important to move on to treatments that will work, leaving by the wayside those that are just diversions.
Timeline for a vaccine
•The WHO also anchors the Solidarity Vaccine Trial, to evaluate the safety and efficacy of several preventive candidates under development. In a recent webinar organised by Project Echo, Soumya Swaminathan, Chief Scientist, WHO, said the expected timeline for a possible vaccine is between 12-18 months. Further, it is important “ultimately to ensure that the vaccine is available to a large number of people.”
•Solidarity II promotes the implementation of serological surveys of SARS-CoV-2. “Understanding the occurrence of SARS-CoV-2 infection is critical for the world to know how frequently infection occurs among different populations, how many people have had mild or asymptomatic infection, how many have been infected but may not have been identified by routine disease surveillance, and what proportion of the population may be immune from infection by SARS-CoV-2 in the future,” the WHO explained.
•The RECOVERY Trial was reportedly set up in record time, taking just nine days from conception to launch, and has recruited over 10,000 patients in 176 U.K. hospitals in just two months. Deputy Chief Investigator of the trial, Martin Landray, said: “What we have achieved with RECOVERY is unprecedented, but it couldn’t have been done without the support and commitment of everyone involved .”
•It tests existing drugs on hospital in-patients with suspected or confirmed COVID-19. Each participant is randomised to receive either standard hospital care, or one of four active treatments. Besides its recent success with Dexamethasone, it also uses Lopinavir-Ritonavir, Azithromycin, Tocilizumab, and convalescent plasma. The HCQ arm was dropped. Ed Juszczak, associate professor - director, NPEU Clinical Trials Unit, Oxford university notes the path-breaking nature of such trials. “For this trial, the timeline has been re-written. The timescales have gone from months and years to hours and days, which is just phenomenal, and shows what’s possible.”
What is the voting process? What are some of its distinguishing features from the general elections?
•The story so far: Another round of Rajya Sabha elections has been completed. Polls to some seats were postponed in view of the situation caused by the novel coronavirus outbreak. All the 19 seats for which balloting was held had clear winners, but there was a hint of controversy about who ought to have been allowed to vote or barred from voting in Manipur. Such issues arise mainly due to the interpretation of rules and features peculiar to the Rajya Sabha elections. Cross-voting, breach of confidentiality by showing the ballot/vote to a person other than the member’s own party’s agent, and eligibility to vote under certain conditions are common grounds for objections to be raised. There are several features that distinguish elections to the Council of States, or the Upper House of Parliament, from the general elections.
What is peculiar to the Rajya Sabha polls as far as the electorate is concerned?
•Only elected members of the State Legislative Assemblies can vote in a Rajya Sabha election. The legislators send a batch of new members to the Upper House every two years for a six-year term. A third of Members of Parliament in the Rajya Sabha (which is a permanent House and is not subject to dissolution), from each State retire once in two years and polls are held to fill up the vacancies. In addition, vacancies that arise due to resignation, death or disqualification are filled up through bypolls after which those elected serve out the remainder of their predecessors’ term.
•Voting is by single transferable vote, as the election is held on the principle of proportional representation. In other words, a bloc of MPs belonging to one or more parties can elect a member of their choice if they have the requisite numbers. This is to avoid the principle of majority, which would mean that only candidates put up by ruling parties in the respective States will be elected.
•The Delhi and Puducherry Assemblies elect members to the Rajya Sabha to represent the two Union Territories.
When are the elections held?
•Polling for a Rajya Sabha election will be held only if the number of candidates exceeds the number of vacancies. Since the strength of each party in the Assembly is known, it is not difficult to estimate the number of seats a party would win in the Rajya Sabha poll. For instance, if there are four seats to be filled up, and the ruling party and its allies command a two-thirds majority, and the Opposition a third, it will mean that the election will go three seats to one in favour of the ruling party. In many States, parties avoid a contest by fielding candidates only in respect to their strength. Where an extra candidate enters the fray, voting becomes necessary.
•Candidates fielded by political parties have to be proposed by at least 10 members of the Assembly or 10% of the party’s strength in the House, whichever is less. For independents, there should be 10 proposers, all of whom should be members of the Assembly.
•A single transferable vote means electors can vote for any number of candidates in order of their preference. A candidate requires a specified number of first preference votes to win. Each first choice vote has a value of 100 in the first round. To qualify, a candidate needs one point more than the quotient obtained by dividing the total value of the number of seats for which elections are taking place plus one. For instance, if there are four seats and 180 MLAs voting, the qualifying number will be 180/5= 36 votes or a value of 3,600. Normally, the results are clear after one round itself. The extra candidate is eliminated for want of enough first preference votes.
•However, counting may go to the second round, if more than one candidate fails to get the specified number. In such a situation, the second preference polled by the candidates (in ballots where the first preference has gone to those already qualified) will be transferred to their kitty, but with a diminished value. The total value of the votes polled by the remaining candidates both as first and subsequent preferences would be used to decide the winner.
Why is there no secret ballot in the Rajya Sabha elections?
•The Rajya Sabha polls have a system of open ballot, but it is a limited form of openness. As a measure to check rampant cross-voting, which was taken to mean that the vote had been purchased by corrupt means, the system of each party MLA showing his or her marked ballots to the party’s authorised agent, before they are put into the ballot box, has been introduced. Showing a marked ballot to anyone other than one’s own party’s authorised agent will render the vote invalid. Not showing the ballot to the authorised agent will also mean that the vote cannot be counted. And independent candidates are barred from showing their ballots to anyone.
Why does not ‘None of the Above’, or NOTA, apply to the Rajya Sabha polls?
•The Election Commission of India (ECI) issued two circulars, on January 24, 2014 and November 12, 2015, giving Rajya Sabha members the option to press the NOTA button in the Upper House polls. However, in 2018, the Supreme Court of India struck down the provision, holding that the ‘none of the above’ option is only for general elections held on the basis of universal adult suffrage, and cannot be applied to indirect elections based on proportional representation.
Does cross-voting attract disqualification?
•No. The Supreme Court, while declining to interfere with the open ballot system, ruled that not voting for the party candidate will not attract disqualification under the anti-defection law. As voters, MLAs retain their freedom to vote for a candidate of their choice. However, the Court observed that since the party would know who voted against its own candidate, it is free to take disciplinary action against the legislator concerned.
Can a legislator vote without taking oath as a member of the Assembly?
•While taking oath as a member is for anyone to function as a legislator, the Supreme Court has ruled that a member can vote in a Rajya Sabha election even before taking oath as legislator. It ruled that voting at the Rajya Sabha polls, being a non-legislative activity, can be performed without taking oath. A person becomes a member as soon as the list of elected members is notified by the ECI, it said. Further, a member can also propose a candidate before taking oath.
📰 Who does Galwan Valley belong to?
Has China staked claim to it before? Why do maps paint a complicated picture? Where is the LAC?
•The story so far: On June 15, the worst violence on the India-China border since 1967 claimed the lives of 20 Indian soldiers. The clash occurred in the Galwan Valley, which hasn’t been a site of conflict since 1962. On June 19, the Chinese Foreign Ministry in a statement claimed that the entire valley is located “on the Chinese side of the Line of Actual Control (LAC)”, which followed a statement from the People’s Liberation Army stating that “China always owns sovereignty over the Galwan Valley region”. India has described the claims as “exaggerated and untenable”.
Where is Galwan Valley?
•The valley refers to the land that sits between steep mountains that buffet the Galwan River. The river has its source in Aksai Chin, on China’s side of the LAC, and it flows from the east to Ladakh, where it meets the Shyok river on India’s side of the LAC. The valley is strategically located between Ladakh in the west and Aksai Chin in the east, which is currently controlled by China as part of its Xinjiang Uyghur Autonomous Region. At its western end are the Shyok river and the Darbuk-Shyok-Daulet Beg Oldie (DSDBO) road. Its eastern mouth lies not far from China’s vital Xinjiang Tibet road, now called the G219 highway.
Where does the Line of Actual Control lie?
•The LAC lies east of the confluence of the Galwan and Shyok rivers in the valley, up to which both India and China have been patrolling in recent years. After the June 15 clash, however, China has claimed the entire valley lies on its side of the LAC. Since early May, China has been objecting to India’s road construction activities at the western end of the valley, in the area between the Galwan-Shyok confluence and the LAC. Beijing is now saying the entire valley is on its side of the LAC, which pegs the line further west near the Shyok river. India has rejected the claim as “exaggerated and untenable”.
Are China’s claims new?
•Most Chinese maps show most of Galwan river on China’s side of the line, but short of the confluence. This broadly corresponds with the LAC as India sees it – and in India’s view, as China saw it, until recently. “Chinese maps that I have seen show almost all of the Galwan River as lying within the territory China claims in the area,” said M. Taylor Fravel, a professor at the Massachusetts Institute of Technology and author of Strong Borders, Secure Nation: Cooperation and Conflict in China’s Territorial Disputes. “The one discrepancy would be the western tip of the Galwan River as it meets the Shyok River. Here, the last few kilometres of the Galwan River are often depicted as lying beyond China’s border.”
What do maps tell us?
•Maps paint a complicated picture. As Manoj Joshi of the Observer Research Foundation notes, in 1959, then Premier Zhou Enlai said a 1956 map portrayed the correct alignment. This showed the entire Galwan Valley as a part of India. However, in June 1960 China put out a map claiming sovereignty over the valley. A Chinese map from November 1962 also claims the entire valley, but subsequent maps have not shown the western tip of the river as a part of China.
By citing its territorial claims, can China alter the Line of Actual Control?
•Territorial claims and LAC claims are not the same. Regardless of whether or not China claims territorial rights to the valley, as one scholar suggested this week, the LAC that both countries abided by until recently ran through the valley. The distinction between territorial claims and LAC claims is sometimes blurred. The LAC refers to territory under the effective control of each side, not to their entire territorial claim. For instance, India’s territorial claims extend 38,000 sq km on the other side of the LAC across all of Aksai Chin, but the LAC India observes runs through the valley. It is true that the LAC has never been demarcated and there are differences in perception of where it lies in more than a dozen spots, but there have not been previous incidents in the valley. By now staking a claim to the entire Galwan Valley and up to the confluence of the rivers, China is, in India’s view, unilaterally altering the LAC here. According to the 1993 Border Peace and Tranquility Agreement (BPTA), India and China agreed to “strictly respect and observe the LAC between the two sides”. This referred to the LAC at the time, rendering irrelevant the line of actual control in 1959 or 1962. It also says that “when necessary, the two sides shall jointly check and determine the segments of the line of actual control where they have different views as to its alignment.” Clarifying the LAC has also been explicitly codified in the 1996 agreement on confidence-building measures and subsequent agreements. China, however, has refused to exchange maps in the western sector to take this process forward. The BPTA also said “the two sides agree that references to the line of actual control in this agreement do not prejudice their respective positions on the boundary question.”
📰 Galwan Valley | A spur in the grand rivalry
The mountains of the Galwan region are of high strategic value for both nations
•The deadly clash at patrolling Point 14 on a ridge line overlooking the fast flowing Galwan river in eastern Ladakh, in which 20 Indian soldiers were killed, echoes episodes of the Great Game — the late 19th century tussle where colonial Britain worked feverishly to block Russian influence from permeating through the mountainous “gates” of India.
•There were multiple fronts of the Great Game, including Central Asia and Afghanistan, but Ladakh, starting from Leh, known for its lucrative trade through the lofty Karakoram Pass, into the heart of Xinjiang, had become an important spur in this grand imperial rivalry.
•But two decades into the 21st century, India and China — two aspirational Asian nations — are following this trail of rivalry at strategic pivots along their contested mountainous borders.
New road
•Point 14, overlooking the Galwan river valley, is one of these key fulcrums, over which the Indian Army and the People’s Liberation Army of China brutally clashed with barbed wired rods, stones and rocks on the night of June 15. The area, from where the Chinese were supposed to withdraw, following a June 6 understanding, is of considerable strategic value.
•India’s newly built Darbuk Shyok Daulat Beg Oldie (DSDBO) road, which leads to the base of the legendary 18,176-feet high Karakoram Pass, is within striking distance from this vantage point in the high mountains. In case the Chinese manage to build an observation tower in this area, they can disrupt traffic over an under-construction bridge along the DSDBO road, using heavy weapons. Understanding the strategic value of this location, it is hardly surprising that the soldiers following Col. Santosh Babu laid down their lives in a bid to prevent a permanent Chinese encampment near Point 14.
•Traditionally, the Galwan Valley area has been part of the winter trade route that linked Leh with Yarkand and Kashgar across the Karakoram Pass, when frozen rivers allowed caravans to progress towards their destinations. From Leh, the caravans breached the Ladakh range at Chang La pass, reaching Darbuk, Shyok village on their way to the Karakoram Pass via Daulat Beg Oldie (DBO). Once the pass was crossed, traders, often in company of monks and scholars, headed for Yarkand and Kashgar, where British India had opened a consulate in a building complex called Chini Bagh. Much later, a motorable road was built from Leh. It entered the Nubra Valley, cutting through the Ladakh range via the 18,600-feet Khardungla Pass and heading to the base of Saser Kangri. Thereafter, a track headed to Murgo — linking up with the DSDBO route.
•But the Galwan Valley is also not far from Aksai Chin, which is occupied by China. China’s highway number G219 passes through Aksai Chin, which is a vital artery linking the sporadically restive Tibet and Xinjiang, the gateway to Beijing’s ambitious Belt and Road Initiative, heading in the direction of Central Asia en route Europe. The Chinese have long established Heweitan — 48 km northeast of the LAC as the crow flies — as their main base servicing the Galwan Valley posts. Incidentally, Heweitan was also a launch pad for mounting an offensive during the 1962 India-China war.
Chinese claim line
•In order to protect their strategic road in Aksai Chin built in the 1950s, the Chinese have unilaterally expanded their territorial claim line along commanding heights, including the Galwan Valley. In response, India, in mid-1962, established a post opposite Samzungling, an area from where the 80-km-long Galwan river originates before joining the Shyok river, which in turn merges with the Indus.
•During the 1962 war, a Chinese battalion destroyed this hopelessly outnumbered Galwan Valley post, after fierce combat, which lasted 24 hours.
•Despite bouts of violence in its recent history, Galwan Valley was so named during the less brutal encounters of the Great Game. The Galwan river was named after Ghulam Rasool Galwan, a Ladakhi adventurer and explorer, who had been part of many European explorations, including two in 1890 and 1896 led by Francis Younghusband — a British explorer and Army officer, who became famous for his role in blocking Russian advances in Tibet.
📰 Apparel exports slide 73% in April-May
Major buyers in U.S., EU cancelling orders or invoking force majeure; industry demands govt. support
•Textile and apparel exports during April and May this year declined 73.1% (in dollar terms) compared with the same months last year, according to quick estimates of exports released recently by the Ministry of Commerce.
•Textiles and apparel worth $6,066 million were exported in April-May 2019 while it was $1,634 million this year.
•Cotton textile exports during April and May this year were 64.6 % lower compared with the same period last year. Export of manmade (MMF) yarn, fabrics and made-ups was 71.1 % lower during April-May 2020 compared with the same period last year while ready-made garment exports declined 78.1 %, according to the data shared by the Cotton Textiles Export Promotion Council (Texprocil).
•Texprocil chairman K.V. Srinivasan said in a press release that export of cotton textiles between April and February last financial year was $9,405 million against $11,262 million during the year-earlier period. Export of cotton yarn declined steeply, almost 28%, during this period and in April and May this year too, export of cotton yarn fell sharply.
•Buyers in the U.S. and European Union (EU), the two major destinations for Indian cotton textiles and clothing, were cancelling orders or invoking force majeure clauses within their contracts. Buyers of cotton yarn were demanding a 15% to 20% price reduction.
Raise competitiveness
•“This is a matter of concern and the government should support the industry,” Mr. Srinivasan said. “It should cover cotton yarn and fabrics under the scheme to reimburse State and Central levies. It should also enhance the overall competitiveness of the textile industry so that India becomes a hub for fabric and yarn production to serve the domestic and export markets,” he added.
•Siddhartha Rajagopal, executive director Texprocil, said the government should come out with clear measures to boost exports so that India does not lose out to competing countries.
•“Textile and clothing exports were already weak last year and then came COVID-19,” he said. “Buyers are cancelling or re-negotiating orders. Textile and clothing exporters need production-linked incentives so that they are able to compete in the international market. Cotton yarn should also get the 3% interest subvention benefit”.
•Observing that exporters were awaiting a nod to export PPEs and MMF masks, Mr. Rajagopal said there were opportunities that India must not lose out on as countries such as Bangladesh and Vietnam already had advantages in the international market.
📰 Antibodies from convalescent plasma protect against COVID-19
Small animals that received high dose of antibodies did not lose weight and the amount of virus in the lungs was low
•A team of scientists led by Dennis R. Burton from the Scripps Research Institute has discovered that neutralising antibodies present in the blood of COVID-19 infected who have recovered offers powerful protection against novel coronavirus in animals. The researchers found that passive transfer of neutralising antibodies into Syrian hamsters protects them against the disease when exposed to the virus. The protection was found when antibodies at high dose were transferred to the animals.
Role for antibodies
•The small animals that received high dose of antibodies did not lose weight and the amount of virus in the lungs was low compared with those that received low dose of the antibodies and the control group. “The study suggests a role for neutralising antibodies in prophylaxis, and potentially therapy, of COVID-19. The neutralising antibodies define protective epitopes to guide vaccine design,” they write in a paper published in Science.
•Prior to transferring and testing the ability of the antibodies to protect the animals from the virus, the researchers tested it on human cell cultures and found the antibodies to have superior ability to protect against the virus.
•Two different antibodies in five different concentrations were tested on the small animals to evaluate dose-dependent protection. The highest dose tested was 2 mg/animal and the lowest dose was 8 microgram/animal. The animals were challenged with the virus 12 hours after the antibodies were transferred. Lung tissues were collected to measure viral load on day 5 post virus challenge.
•In contrast to the antibody to receptor-binding domain of the virus, the less potent and incompletely neutralising antibody showed no evidence of protection at any concentration compared to the control animals.
Promising study
•The authors state that the efficacy of the antibodies in Syrian hamsters is “promising” and suggest that human studies be undertaken based on animal trial results.
•Incidentally, the researchers also identified one antibody that can neutralise the 2002 SARS virus.
•According to the release, the antibodies can be injected into patients in the early stage of the disease to reduce the viral load and thus protect the patient from progressing to the severe form of the disease. “The antibodies also may be used to provide temporary, vaccine-like protection against SARS-CoV-2 infection for healthcare workers, elderly people and others who respond poorly to traditional vaccines or are suspected of a recent exposure to the coronavirus,” the release says.
•The antibodies can then be mass-produced either as a treatment to prevent deterioration of the disease and as a preventive vaccine, as in the case of Ebola virus, the release notes.
•“If further safety tests in animals and clinical trials in people go well, then conceivably the antibodies could be used in clinical settings as early as next January,” the researchers say in the release.
•More than 1,000 antibody-producing immune cells called the B cells were first isolated. These antibodies were isolated based on their ability to bind to the virus and prevent it from infecting the test cells.
Gene sequence
•Each of the 1,000 immune B cells produced a distinct antibody against the virus. In order to mass-produce the antibody, the scientists obtained the gene sequence of each antibody. They then screened each antibody and 33 antibodies that could block the virus from binding to the test cells were identified. They identified one antibody that could also protect hamsters against heavy viral exposure.
