COVID-19 and Medical Solutions
According to the World Health Organization (WHO) the virus SARS-CoV-2, has caused the world’s largest pandemic infecting nearly six lakh people globally.
Considering the grave scenario the discovery of vaccine and the licensed use of a drug has been ruled out as an immediate solution noting that even if the process is fast-tracked, a process would take over 18 months to be ready for use.
Hence, WHO and other health agencies are re-looking the efficacy of known therapies such as convalescent plasma therapy and drugs to treat COVID-19.
The known drugs include a combination of two HIV drugs- lopinavir and ritonavir, anti-malaria medications- chloroquine and hydroxychloroquine, and antiviral compound namely, remdesivir.
Efficacy of Known Drugs:
The Indian Council of Medical Research (ICMR), has suggested the use of hydroxy-chloroquine to contain the spread of SARS-CoV-2 (Coronavirus) for restricted populations.
Also, the small study conducted in France found that it led to a significant reduction in viral load in COVID-19 patients.
However, Hydroxychloroquine is known to have a variety of side-effects, and can in some cases damage the organs like the heart.
The combination drug, ritonavir/lopinavir was introduced to treat HIV infections.
It was experimented in China with COVID-19 patients but there was no significant difference observed among them.
Although the drug is generally safe, it may interact with other drugs usually given to severely ill patients with other diseases.
The drug could cause significant liver damage.
The drug, remdesivir is developed to treat Ebola and related viruses, is being tested to find out whether it can be used on COVID-19 patients.
According to WHO, the drug helps to prevent COVID-19 viral replication.
It has the best potential and can be used in high doses without causing toxicities.
Relapse in Patients Recovered from COVID-19:
Patients who test positive for COVID-19 develop protective antibodies. Theoretically, there can be a relapse even in patients who have antibodies. There are various reasons for such relapsing of COVID-19, some of them are:
The probable mutations, is one of the major reasons for making an individual vulnerable to reacquire the COVID-19 infection.
b)Unknown Behaviour of the Virus:
Since the exact behaviour of the novel coronavirus is still being studied, immunity against it is not fully understood.
At this stage, it is not fully understood as to how long the antibodies provide protection against the viral infection.
Also, in the absence of any vaccination, it is not known whether the immunity acquired by the persons is permanent.
It has been observed that a “false negative” RTPCR test — the RNA test being conducted to diagnose COVID-19 infection — can lead to a patient testing positive a second time after testing negative in between.
Withdrawal from EPF Accounts
The Union Ministry of Labour and Employment has notified an amendment to the Employees’ Provident Funds (EPF) Scheme allowing members to withdraw non-refundable advance amounts in the wake of the COVID-19 pandemic.
The notification amends the EPF Scheme, 1952 by inserting Sub-Para (3) under Para 68L of the EPF Scheme, 1952.
This permits withdrawal not exceeding the basic wages and dearness allowance for three months or up to 75% of the PF balance, whichever is lower, in the event of outbreak of epidemic or pandemic.
Earlier, non-refundable advances were permitted only for specified purposes such as housing and marriage. Even these were permitted only where the employee has put in a minimum service period.
Since the outbreak of COVID-19 had been declared a pandemic for the entire country, all employees of establishments and factories in India who are members of the EPF scheme would be eligible for the amended scheme.
Recently, the Finance Minister — as part of the Pradhan Mantri Garib Kalyan Yojana — said that the government will bear the cost of the provident fund contributions, both of the employer and employees—12% each—for the next three months for those establishments which have up to 100 employees and 90% of whom are earning less than ₹15,000 per month as salary. It also relaxed withdrawal conditions from EPF accounts.
Public Health vs Private Information
Recently, a list containing private information of suspects of Covid-19 was not only found on social media but also some state governments, officially, have made public the disclosure of data of those under quarantine.
Such disclosures have raised concerns over balancing the importance of public health, doctor-patient confidentiality and the fundamental right to privacy.
In the absence of a national protocol or law, state governments are divided on the approach to handle the situation.
While some states have put data in the public domain to better inform citizens, other states are making efforts to protect identities to avoid panic and to respect privacy.
For contact tracing and ensuring social isolation, states are relying upon informing communities.
Karnataka has published a district-wise list of those who are home-quarantined with travel details and exact addresses on the Department of Health and Family Planning’s website.
Many states including Delhi, Gujarat, and Karnataka have instructed local authorities to label houses where individuals are quarantined.
However, West Bengal, which has put peoples under home surveillance and in isolation, has not disclosed the identities of individuals or hospitals in which they are kept.
There is no law which backs disclosure of personnel information to the public.
The Code of Medical Ethics prescribed by the Indian Medical Council, bars disclosure of information relating to the patient learnt during the treatment except in certain cases.
The exceptions include circumstances where there is a serious and identified risk to a specific person and/or community; and in the case of notifiable diseases.
Even the Ministry of Health guidelines for surveillance provide for sharing of patient/contact information with the state or district level surveillance units of the Integrated Disease Surveillance Programme or any other authority that first comes in contact with the patient.
But there is no provision in these guidelines to make patient details public or even naming missing patients.
Legislation invoked to handle a public health emergency, the Epidemic Act, 1897, and the Disaster Management Act, 2005, provide legal immunity to action taken in “good faith” during this time.
The provision states that officers and employees of the Central/ State Government, shall be immune from legal process in regard to any warning in respect of any impending disaster communicated or disseminated by them in their official capacity or any action taken or direction issued by them in pursuance of such communication or dissemination.
Even, under the Data Protection Bill, a data fiduciary (the government) can process personal data of individuals to respond to a medical emergency where the life of a data principal is at risk.
It can also be processed in the face of an epidemic, outbreak of diseases or any other threat to public health.
The COVID-19 pandemic can fall under these categories.
Publishing names of individuals, along with their addresses on social media or in front of their houses puts families at risk of physical or emotional distress.
It will also create more panic among the people.
If challenged in court, disclosure of personnel information by the government will have to pass the “proportionality test” prescribed by the Supreme Court in the landmark 2017 Puttaswamy verdict that recognised the fundamental right to privacy.
Proportionality test is a legal method used by constitutional courts, to decide hard cases, that is cases where legitimate rights collide.
In such a case, a decision necessarily leads to one right prevailing at the expense of another.
Disclosures that are needed for contact tracing need to be restricted to public officials who are entrusted with enforcing the quarantine.
Personal details must be masked when disclosed in public.
Counter cyclical capital buffer (CCyB) for banks
Reserve Bank has deferred implementation of countercyclical capital buffers (CCyB) and extended the realisation period for export proceeds.
The RBI had put in place the framework on counter-cyclical capital buffer (CCyB) on February 5, 2015, wherein it was advised that the CCyB would be activated as and when the circumstances warranted.
What Is a Countercyclical Capital Buffer (CCyB) in Banking?
The countercyclical capital buffer is intended to protect the banking sector against losses that could be caused by cyclical systemic risks increasing in the economy.
Countercyclical capital buffers require banks to hold capital at times when credit is growing rapidly so that the buffer can be reduced if the financial cycle turns down or the economic and financial environment becomes substantially worse.
Banks can use the capital buffers they have built up during the growth phase of the financial cycle to cover losses that may arise during periods of stress and to continue supplying credit to the real economy.
The rule was first introduced in Basel III as an extension of another buffer (called the capital conservation buffer). Basel III is a voluntary set of measures agreed upon by central banks all around the world. These measures were drafted by the Bank of International Settlements’ Basel Committee on Banking Supervision in response to the financial crisis of 2007-09, in order to strengthen regulation of banks and fight risks within the financial system.