May 20: International Day of Clinical Trials

During the past year, as scientists in different parts of the world began developing vaccines against the Covid 19 virus, we have gradually become familiar with the idea of clinical trials and their importance in our lives. Every time a new drug, a new vaccine, a new medical device or a new treatment procedure is developed, there is a trial run done to make sure that they are safe for use in humans and are sufficiently efficient to treat a specific health condition. The trial run and all the steps involved in it is a clinical trial. 

Clinical trials are done in 3 phases. In Phase 1, the researchers administer the drug to participants to see whether the drug is safe to use and the highest dose that can be given to humans without any adverse side effects. During Phase 2, researchers administer the safest dose and try to figure out whether the new drug, vaccine or experimental treatment is effective in combating the specific disease that it is designed to treat. For example, a phase 2 trial drug for cancer may successfully lead to the shrinking of solid tumours in participating cancer patients. Phase 3 of the trial aims to find out how safe and efficient the new drug or treatment is compared to the current ones that are in use. The participants are divided into 2 groups, one group is administered the new, experimental treatment, the other group is given the treatment already in use or in case none is available, a sugar pill. Neither the doctors nor the patients in this phase of the study know which individual patient receives which type of treatment in this phase. If the new drug, vaccine treatment is found to be safe enough and more beneficial compared to the older ones, the authorities grant approval for its widespread use.

A trial run involves people who are selected on the basis of specific criteria like age, sex, population group, suffering from a disease at present or with a history of a specific illness. The details of the procedure, potential risks and benefits of the new treatment is explained to the participants and consent is taken before proceeding.

Clinical trials are not just needed for a newly prepared drug or treatment. If an already in use drug that was effective in treating a disease in adults is found to treat the same disease in children, new clinical trials need to be done in children before it is approved. Sometimes, there are new discoveries like a drug previously used for treating malaria contains properties that would be helpful for patients suffering from another disease caused by a virus. This old drug with a new purpose then undergoes a trial run to see how well it works against the viral disease.

Homophobia in Science

May 17 was observed as the International Day Against  Homophobia, Transphobia and Biphobia.

Indian academic spaces for a long time have been homophobic and transphobic. Many research fellows, students and even scientists pass homophobic and transphobic comments at the workplace, discriminate against queer and trans people who are fellow students or colleagues and rarely face any consequences. When it comes to the annual discussions on gender equity at many such institutions, historical injustice, discrimination and toxic behaviour experienced by the queer and trans folk in academia are conveniently left out of the talking points. For a queer or trans person working in such a toxic workplace, there is no one to turn to for help and register a complaint. Many people from the LGBTQIA community who are working in the toxic and hyper-masculine world of Indian science and academia suffer from mental health issues as a result of these experiences. 

There is also an issue of visibility as right now, very few queer and trans people are holding positions of power in the world of Indian academics, especially in STEM subjects. A greater number of LGBTQIA scientists would encourage more LGBTQIA youth to take up science, pursue scientific research, and also bring about an inclusive change in science policymaking in this country. Indian science and education policies would be truly equitable when they acknowledge the discrimination and de-humanisation faced by the LGBTQIA people and attempts to right the historical wrongs through steps that ensure increased representation, increased visibility through affirmative actions and strict institutional action against homophobic, transphobic behaviour in the workplace 

COVID 19 infection even after vaccination

Vaccines are the only way to prevent viral diseases like that caused by Covid 19 infection. Multiple vaccines that can effectively protect against illness caused by Covid 19 virus have already been developed and are being administered to people all over the world. But, a small number of people may get the Covid 19 disease even after being vaccinated. One of the reasons for getting  Covid 19 infection after vaccination may be due to a new variant of the virus that the vaccine is not very effective against. Some people may have already been infected by the Covid 19 virus before taking the vaccine doses. Most of the Covid 19 vaccines take a couple of weeks to work, therefore a vaccinated person may become infected with the virus because the vaccine has not had enough time to produce anti-Covid 19 antibodies. Frontline workers and healthcare professionals may catch the disease even after being vaccinated due to continuous exposure to Covid 19 patients. Although vaccines are not 100 percent efficient at preventing Covid 19 virus infection, the risk of patients falling severely ill, being hospitalized or dying is reduced to a great extent because of the protection offered by vaccines. A vaccinated person is likely to suffer a mild Covid 19 illness or be entirely asymptomatic.  Therefore, it is important to remember that the vaccines currently being used against Covid 19 may not prevent infection by the Covid 19 virus, the transmission of the virus but will protect against serious disease and fatalities.

Vaccine Booster Dose Gap

Vaccines mimic an actual infection by a microbial pathogen like a bacteria or virus, cause our bodies to react to it and produce combative antibodies and thus provide protection from naturally occurring infectious agents. The protection provided by a vaccine makes the individual “immunized”. A vaccine can imitate a pathogen contain an alive or dead form of the microbe or parts of the microorganism that causes the host’s body to produce specific anti-pathogen antibodies and activate T cells. Vaccines may cause mild symptoms but not a serious disease caused by the pathogen. As a result of the vaccine, the individual’s body now remembers the specific infectious pathogen, it contains specific B cells, T cells, antibodies to fight it. But after a long time, the immune system may begin to forget. A second dose of vaccine called a booster is required at that time to help the immune system remember the pathogen once again and create new pathogen-specific antibodies, lymphocytes. The right time to administer a second dose or a booster is different for different types of vaccines, boosters may be given annually or within a few weeks of the first dose. It is important to get the booster doses as it will help our immune system remember the pathogens and continue to provide us with immunity.

Covid Crisis frontline: ASHA workers

Accredited  Social Health  Activist (ASHA) workers are women who belong to the local community or villages and work as community health workers. As a part of the National Rural Health Mission established by the Indian government in 2005, women from local communities were trained to educate, spread awareness about immunization programmes and keep the local primary health centres updated about the various health conditions of villagers. The remuneration she/they receive are sometimes fixed salaries or incentives based on their performance.She/they motivate villagers to vaccinate their children, encourage practices like surgical sterilization, use of contraception, breastfeeding and giving birth in hospitals. She/they are also equipped to provide first aid care and essentials like Oral Rehydration solutions(ORS), birth control pills, condoms, chloroquine, iron-folic acid tablets. During the Covid pandemic, they have acted as frontline workers, worked long hours without receiving adequate financial incentives or personal protective gear. Many have had to arrange for their own transport while making sure that medicines and essential commodities reach the Covid-affected in their communities. It is time we recognize the immense importance of ASHA workers in the rural healthcare system and ensure that they are not overworked and underpaid. It is time we make sure that these working women are provided with proper PPE kits to protect themselves and the support necessary to carry out their work that is saving lives every day.

(In memory of  ASHA activist Ranjana Nirula who died of Covid on 12.05.21)

Ref:

https://web.archive.org/web/20150708120224/http://nrhm.gov.in/communitisation/asha/about-asha.html

COVID Crisis frontline: Crematorium and Cemetery workers

Officially, more than 4000 people are dying everyday of Covid19 infection and the unavailability of basic healthcare facilities in India. The people who are involved in cremation or burial of the dead or  those conducting the last rites in accordance with religious or cultural traditions  have been instructed to wear appropriate personal protective equipment. The PPE  must include gloves, face-shield, goggles to protect eyes, medical mask and closed footwear. There is less chance of transmission of Covid 19  due handling of human bodies compared to diseases like cholera. But a person handling the bodies of deceased could be infected by the virus if they come in contact with the infected body fluid or secretions. The lungs and other organs of the people who died of Covid may also contain live and infectious viruses. As the death toll rises, workers in crematorium and burial grounds are working round the clock. They  often do not have access to  Covid vaccines, testing kits, proper protective equipment, financial support, food and mental healthcare. Many of these frontline workers come from historically marginalized and oppressed communities that still face institutionalised caste- based discrimination. It is time we recognise their roles as frontline workers during this health emergency and endeavour to improve their plight.

The seeds of scientific temper in Indian Constitution

For the first time in its 175-year-old history of publication, Scientific American, one of USA’s leading popular science magazines  openly endorsed a candidate during the campaign for the US presidential election The magazine explained in a statement that the rejection of  evidence based science by Donald Trump, the current president of U.S while preparing policies on health and environment led them to this taking this stand . The lack of science-backed policies had proven particularly disastrous during the ongoing coronavirus pandemic and have resulted in large number of people dying from Covid-19 infections in the U.S. The unprecedented  political stand  by the Scientific American emphasized how  public policies based on scientific facts could save lives and make people’s lives better.

A similar thought could be found in our Indian constitution, embedded in the part that talks about fundamental duties of every Indian citizen.

“It shall be the duty of every citizen of India to develop a scientific temper, humanism and the spirit of enquiry and reform”.

Although this statement was added to the constitution as a part of the 42nd amendment in 1976, the idea of scientific temper has its roots in Jawaharlal Nehru’s The Discovery of India, a book published almost 30 years earlier.In this book, Nehru refers to scientific temper as “the temper of a free man.” He viewed science as the way to solve the numerous economic, political and social problems that India faced after its birth as an independent nation. But according to him, the use of science and technological advancements  towards the development of a nation would not be enough, there was also a need for the citizens of this country and not just the practising scientists, to develop a “scientific temper’,’ that is a rational, critical and  scientific bent of mind.

The word scientific temper had been used in different contexts by European writers before Nehru but he is credited with the current definition of the term. His definition of scientific temper was based on ancient Indian texts like the Buddhist Kalama Suta that asks a student to question,look for evidence and not merely believe something because the teacher said so. Nehru was also inspired by  the social reforms led by Rammohun Roy and  the writings of Prafulla Chandra Roy, often considered to be the founder of modern Indian chemistry, who advocated for growth of scientific spirit,ability to reason among indian students. The Indian parliament adopted the Science Policy Resolution in 1958 that viewed science and technology as a tool to fulfill the country’s  various requirements and also to bring about socioeconomic change.

Our political leaders and policy makers have often behaved in the same way as us. They have often preached about the importance of scientific temper , rational thinking  but  actually relied on astrology or superstitious beliefs. Separating science from its social consequences,many have  lauded Mangalyaan but turned a blind eye to the inequalities that persist in our society based on caste, gender, religion.They have often confused a country’s scientific and technological advancements with  the successful propagating of a scientific temperament among citizens.  Just as we  have confused the idea of reading science in schools and colleges, being a professional or a research scientist in the field of science and technology with the idea of inculcating a scientific temper in the way we think. Having a scientific temper in this day and age would cause us to fact-check the information we receive on social media and look for sources that backup their claims with evidence. Having a scientific temper would allow us to separate evidence- based historical happenings from mythology, it would also prevent us from passing off mythological characters as proof of the scientific achievements of our ancestors. A scientific temper  within us,  would challenge false and grandiose notions about our  ancient past that are not backed up by facts or evidence and instead, focus on creating a future that is defined by well researched, scientific-evidence based public policies.

On National Scientific Temper Day

Seven years ago on this day,Narendra Dabholkar, the eminent Maharashtra-based doctor,rationalist and  social activist who worked relentlessly to eradicate superstitious beliefs and inculcate scientific temper, was shot dead. He had founded an organisation called the Maharashtra Andhashraddha Nirmoolan Samiti (MANS) that campaigned against superstitious practices, black magic, astrology,“miracle cures” and similar exploitative practices promoted by fraudulent godmen in the name of faith. Dabholkar had repeatedly advocated for enacting an anti-superstition law in the state but faced fierce opposition from right- wing groups who accused him of being against the Hindu culture. After his assasination in 2013, the Maharashtra government passed the law against superstitious practices and black magic.Along with MANS, the  All India Peoples Science Network, a national network of a number of People’s Science organisations from all over the country have kept his legacy alive by  observing August 20th as the National Scientific Temper Day. 

The Indian constitution tells the citizens of this country that it is their duty to develop “scientific temper, humanism and the spirit of inquiry and reform“. Jawaharlal Nehru is credited with coining and defining the  term “scientific temper” in his book “The Discovery of India” in 1946. According to him, scientific temper is not merely the study of science or its application but a way of life.Having a scientific temper has got very little to do with whether someone has a degree in science  or is a scientist professionally. Scientific  temper allows  people to reason, be curious and ask questions about the world around them. Those who have a scientific temperament  do not readily  accept  explanations given to them but try to find out  whether it is based on evidence or preconceived ideas or personal prejudices. Whether an explanation comes from the authorities, religious scriptures or textbooks, a person with a scientific temper would not accept it blindly but try to examine the evidence behind the claim. However, over the past few years, instead of trying to inculcate a scientific attitude among the public,many policy makers and television channels have been promoting myths, misinformation and pseudo-science.

When the global COVID pandemic hit this country,  such pseudo-scientific content was seen in TV news channels as well as social media platforms.A couple of months ago, leading science communicators Gauhar Raza and Surjit Singh teamed up to gauge the public understanding of science regarding the  coronavirus pandemic in India. Since COVID came to this country, more than the usual amount of  space and time began to be devoted to the science behind the virus in newspapers and TV channels. Scientists and science communicators started using social media platforms to communicate what a virus is, how this particular virus infects people and what precautionary measures could be taken to prevent the disease. Gradually, with repeated use in the media,scientific jargons like “SARS CoV2″,” PCR”, “RNA” became part of people’s household conversation. But   misinformation also continued to circulate, sometimes suggesting bogus ways to prevent coronavirus infection.  In a recent study, Raza and Singh tried to understand whether the Indian people were more prone to believing pseudoscience,myths  or scientific information from reliable sources during this pandemic. Their survey- based study, conducted both offline and online, involved over 2500 participants and was done in May 2020. The participants, over sixty percent of whom are working men from the upper middle class were asked to fill out a questionnaire that included questions designed to understand their scientific knowledge about the pandemic as well as  how they had formed their opinions. The respondents in the survey were 27 states and UTs of the country but more than half of them belonged to the northern states. Internet was the most popular source of information regarding coronavirus among the participants followed by TV news. Eight out of ten participants knew what  the coronavirus looked like. Most of them also knew about Wuhan, where the virus originated and that the virus could live in animal reservoirs like bats.More than seventy percent of the participants knew how the viral infection spread through sneeze and coughs from one human to another. A large number of participants also knew that viruses could survive longer on metal and plastic surfaces, how long the viral incubation period was and what symptoms were observed in a person suffering from COVID19 infection. The fact that there is a higher chance of  infection if they go out was well known as was the fact that coronavirus infection was not fatal most of the time. An overwhelming majority of respondents said that in the absence of a vaccine or a drug, they understood that measures like social distancing, wearing face masks and frequent washing of hands were the only strategies to prevent infection. Around seventy percent of the respondents were aware of the scientific methods used to test for  COVID19  infection. Half of the participants thought that imposing a lockdown had helped in controlling the pandemic. The decision to close  all religious places  to prevent spread of infection was also supported by most.

Although this study did not include a huge number of participants, it did show that a large percentage of this group of  participants relied on scientific information regarding the  coronavirus pandemic. During the biggest public health crisis of the century, these fellow citizens did not depend on cow urine or other pseudoscientific “miracle cures”, instead they followed scientific advice to socially distance, wash hands and wear face masks. The authors hope that this sense of scientific temper cultivated during a crisis would eventually become the “new normal”.

References:

  1. http://confluence.ias.ac.in/towards-an-index-of-scientific-temper
  2. https://thefederal.com/science/scientific-temper-a-nehruvian-thought-but-very-much-relevant-today/
  3. A Perspective on Scientific Temper in India by Subodh Mahanti (Journal of Scientific Temper,2013)
  4. Scientific Knowledge, Perception and Attitudinal Changes during Corona Pandemic by Gauhar Raza and Surjit Singh(Journal of Scientific Temper,Jan-June 2020)
  5. http://antisuperstition.org/?option=com_content&view=article&id=97&Itemid=80
  6. https://aipsn.in/
  7. https://www.newsclick.in/Scientific-Thinking-Requires-Independence-Thought

Alcohol-based hand sanitizers cannot boost immunity

During the course of the COVID19 pandemic, alcohol-based hand sanitizers have become a popular personal care product. The CDC considers hand sanitizers can be used to clean hands when soap and water are unavailable. Most of these alcohol-based hand sanitizers contain isopropyl alcohol or ethyl alcohol.

Alcohol damages the structure of cell membranes of bacteria and the envelope of viruses. Thus, if alcohol is sprayed on hard surfaces or skin, a large number of these pathogens present on them would be killed. That is why alcohol has been used as disinfectants to clean surfaces or as an antiseptic to clean wounds to prevent the spread of infection.

But alcohol has its limitations. It is not effective in destroying spores or viruses with no outer envelope. Repeated use can cause dryness and irritation if it enters the eyes by mistake.

Many alcohol-based sanitizers are claiming that these substances can boost immunity. Immunity is the protection offered by our body’s immune system against infection by foreign pathogens. Disinfectants like alcohol can clean surfaces or skin killing most of the pathogens present on them. This reduces the chance of infectious germs entering our body. But alcohol has no role in influencing the function of the immune system of our bodies against germs that have already entered and infected us.

Donating blood plasma for therapy

The act of giving blood has saved numerous lives. Patients undergoing surgery or victims of trauma/assaults/accidents who have lost large amounts of blood need transfusion of fresh blood from healthy people to survive. When a person loses a lot of blood quickly, the body goes into a shock and eventually organs stop functioning. Also, patients of chronic blood- related disorders like thalassemia require blood transfusions on a regular basis.

May 8th is observed as the World Red Cross day. The Red Cross 

Our blood contains a number of different components, each with specific functions. The major component is plasma ,it contains water, proteins, nutrients required for body cells and waste materials collected from different parts of the body. Red blood cells carry oxygen to the cells so that they can respire. White blood cells are a part of the body’s immune system and help protect against diseases. Platelets contain substances that make the blood clot during an injury.

The blood plasma contains specific antibody molecules that the immune system develops against pathogens like bacteria and viruses that cause serious infectious diseases. For example, patients who have recovered from a COVID 19 infection are likely to have specific antibodies against the COVID 19 virus in their blood. Plasma donated by these patients could help save the lives of others suffering from serious COVID 19  infections. This method of treating COVID 19 patients, known as convalescent plasma therapy comes as a ray of hope amidst the global pandemic.