A huge
demonstration has been organised in the capital of Azerbaijan by people, shortly
after a violent border clash emerged between the country and its unfriendly neighbour,
Armenia.
Tens of
thousands of people have participated in the demonstration organised at the capital
demanding war.
As many as
sixteen people has lost their lives in the clash happened in the border between
Azerbaijan and Armenia.
Azerbaijan
and Armenia were the members of erstwhile Soviet Union. Post the disintegration
of the union, it emerged as two independent countries.
There is an
unresolved border issue between these countries. Nagorno-Karabakh is the disputed
territory.
The UN
recognizes Azerbaijan’s claim for the territory. But, the region is at present controlled
by ethnic Armenians.
The protest
demanding war has turned violent. The protesters have even entered the Azerbaijan
parliament.
The authority
has used force to disperse the protesters.
The latest
development may push the country to a serious political crisis.
The protest, which has been organised at the time the world was struggling due to a serious disease outbreak, has left the country in dismay.
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A middle-aged woman has been killed and two other ladies injured
in a series of stabbing attacks which has taken place in the European country
of Norway.
The first incident of stabbing was reported from the Norwegian
city of Sarpsborg. The second and third were reported from the same location.
The police alerted the locals as soon as they were informed
about the incident.
A 31 year old man, who is a citizen of Norway, has been
booked in connection with the attacks. The police are verifying whether the person
has any serious mental issues. As per a preliminary report, the culprit is a person
who has a bad criminal history.
It is learned that the accused had a relationship with at
least two of the three women who suffered his stabs.
What makes the case complicated is that the woman who was
killed by the man had no relationship with the man.
The condition of one of the two injured women is serious. The
condition of the other is not too severe and is recovering.
This case is one of the most heinous crimes reported from
the region in the recent history.
Norway is not a crime prone region. It is very peaceful, compared to other countries located in this part of the world.
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The world is likely to witness a fall in the global
fertility rate, as per a recent report published in a reputed International
media house.
The report implies that almost every country may see their population
reduced in the near future.
Are we fully prepared to face this phenomenon? As per
another report, the world is totally ill-prepared for the global crash in
children being born.
It is suspected that the predicted fall in the fertility
rate is likely to have a serious impact on societies across the world – particularly
the western societies.
The phenomenon will affect the developed societies more than
the under-developed and developing societies across the world
Some developed countries such as Spain and Japan may see
their populations reduced by the year 2100.
Generally, fertility rate means the average number of
children a woman gives birth to. The fall in the rate means the average number
of children a woman gives birth to is falling.
Notably, if the rate comes down below the point of 2.1, then the size of
the population starts to fall.
In the year 1950, the average number of children a woman gives birth to was 4.7. Since then the rate has been consistently falling due to various reasons.
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The Court of Arbitration of Sports has overturned the ban
imposed on Manchester City by the UEFA, and reduced the file imposed on the
club by the football organisation from the sum of 30m euros to the sum of 10m
euros.
The two-year ban was originally imposed few months ago after
the irregularities committed by the club had been exposed.
The latest verdict does not abdicate the club of all charges
levelled against it by the UEFA. Meanwhile, it does settle the case in a manner
which is acceptable to both the parties – the club and the UEFA.
The club has done its best to portray the latest verdict as
the victory of the position it has been maintaining since the origin of the financial
irregularity allegation.
The attempt has somewhat succeeded in providing the club the
desired result.
Manchester City is a popular club. It has contributed several
talented players to the world of sports.
It is hoped that the club will not fall under the clutches of such an allegation in the future.
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Andrzej Duda, the incumbent President of the European country
of Poland, has won the Presidential Election, defeating his nearest rival,
Rafal Trzaskowski, with a narrow majority.
The President has wristed around 51.2 per cent of the total number
of votes casted in the Presidential Election.
It is the toughest competition the country has witnessed
since the collapse of the communist rule in the early 1990s.
The victory of Mr. Duda has many political implications. It
has strengthened the position of the conservative faction.
The person whom the incumbent President has defeated in the
Presidential Election, is a member of the liberal faction.
The victory of the conservative leader may reflect in the
future of the relation between the European country of Poland and the most
powerful economic union of the European Union.
The narrowness of the victory margin proves that the political
clout of the liberal faction is increasing in the country and may topple the
dominance of the conservative faction any moment.
Mr. Duda’s retention of the seat of President is a great relief to the conservative parliamentarians.
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The arrest of a regional leader, Sergei Furgal, who is the
governor of Khabarovsk, has sparked protest in the region.
Tens of thousands of people have taken part in a march organised
to register their protest against the arrest of their leader.
Khabarovsk is a region located in the eastern region of
Russia. The arrested governor is very popular in this part of the country –
even more popular than Russian President Vladimir Putin.
There are rumors that Mr. Putin is worried about the rising
popularity of the Khabarovsk Governor in the region. Many believe that the move
to arrest the governor was politically motivated.
During the march, many participants have raised provocative
slogan against Russian President Vladimir Putin.
The arrested governor faces serious murder charges. He is accused
of having ordered the killing of several business people nearly 15 years ago.
Notably, Mr. Furgal defeated the candidate of Mr Putin’s
United Russia party in elections two years ago.
Though His party, the ultra-nationalist Liberal Democrat Party of Russia, is usually seen as loyal to the Kremlin, the growth his party has achieved is definitely irritating for the Russian President and his party.
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Catalonia, the most popular autonomous region in Spain, has
made face masks mandatory in public for all those aged over five.
Notably, the move has come after the region has witnessed a
surge in new cases of coronavirus.
The new rule means that anyone caught without a mask faces the serious
fine punishment of around €100.
One of the agricultural regions in the region Segrià has witnessed a surge
in new cases in the recent past.
Anyway, the national situation is largely under control. So far, the
country had recorded 252,513 cases and 28,396 deaths.
It seems that the country will come back to normal soon. Though
earlier the WHO contradicted the claims in connection with the usage of masks,
now it supports the idea of making masks mandatory in public.
Many countries across the world have already introduced this policy in their respective regions. There is no wrong in trying anything if it can assure some relief from the crisis.
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Numerous police and protesters have been injured in the violent
confrontation taken place outside the National Assembly in the Serbian capital
Belgrade.
Actually, the protest began peacefully on Tuesday evening.
But, it turned violent later, paving way for the confrontation.
The participants of the protest were mostly students and their
families, angered by a move to re-impose a weekend curfew because of a rise in
coronavirus infections.
It was when the protesters broke into the assembly that the
police intervened to bring the situation under control.
The police had to even use tear gases to prevent the
situation from going out of control.
Far-right nationalists have been blamed for stirring up the
unrest and storming the assembly building. As per a media report, they include
an MP who has pushed anti-vaccine and anti-5G conspiracy theories.
It is unfortunate that a section of Serbian population pays less heed to the call for the restrictions.
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A virus is not even a living thing, but yet has managed to get a technologically and militarily advanced human-world in its entirety into a stupefying and unimagined lock-down, while every other animal moves gracefully free! It is enigmatic to realize that this virus which is just 0.06 – 0.14 Microns in size and a mere structure of a single strand of nucleic acid, some lipids, proteins and carbohydrates and that which actually needs a host to propagate has humbled the scepter wielding powers of the world.
About the virus: The Corona virus has spikes on it which gives it the appearance of a crown or corona, from which it derives its name. It is with these spikes that the virus gains entry into the host cells and multiplies and then causes all the ensuing destruction. It was initially named the novel corona virus and subsequently as the Severe Acute Respiratory Syndrome Corona Virus – 2 (SARS-CoV-2). The virus is presumed to have originated in bats and then moved to probably the pangolin before it infected the humans for the first time in Wuhan, Hubei province in China. The Corona Virus disease 2019 or the COVID-19, is now a global pandemic affecting over 3.2 million people and counting, in 210 countries and territories of the world.
How does the virus spread? The virus is spread mainly via droplets but can be aerosolized when someone coughs or sneezes and can remain stable in the atmosphere for up to 3 hours in the aerosol, depending on factors such as atmospheric temperature, humidity and ventilation. It can remain on hard surfaces from 24 hours on cardboards and to as many as 3 days on steel and plastics. There are reports that the virus is excreted via the stools also. The virus has a high reproduction number and therefore spreads easily. So the common mode of infection is when a person with the virus contaminated hand touches the nose, mouth or eye or inhales the virus containing aerosol, with the virus thus gaining entry into the lungs.
The incubation time or the time between the entry of the virus into the body and appearance of symptoms is an average of 4 to 5 days, but can range from 1 to 14 days. An infected person can spread the virus even when he has no symptoms and thus be an asymptomatic carrier of the virus. It is the combination of the high infectivity along with the ability of a person to infect even when he is asymptomatic, that has been responsible for the rapid spread and the pandemic proportions of the disease.
How does it damage the lungs and other organs? The primary target of the virus is the respiratory system and the virus uses its spike proteins to enter the lung cells by binding to a receptor called angiotensin converting enzyme 2 (ACE-2). This enzyme is expressed in the heart also, in addition to the lungs and also plays a key role in the functioning of the heart and development of high blood pressure in humans. Once the virus enters the lungs it begins to multiply and the symptoms during these early stages are mostly mild or can be none at all. The protective mechanisms in the body tries to fight and suppress the virus by producing immune cells and also chemicals called cytokines. In some patients however, the release of these chemicals can be sudden and severely out of proportion, a phenomenon called, the ‘cytokine storm’ which ultimately turns out to be damaging to the patient himself. The chemical release damages the lungs causing breathing difficulty and the failure of lungs to oxygenate the blood results in decreased oxygen supply to all organs affecting their normal functioning too. When the kidneys start failing, the waste products start accumulating in the body, further depressing the function of the organs and also causes additional bacterial infection in the blood and organs causing septic organ failure.
What are the symptoms and signs of COVID-19? The usual symptoms are fever and dry cough but conspicuously a runny nose and gastrointestinal symptoms like diarrhea and vomiting are uncommon, though they can occur. 80% of the infected patients have no pneumonia (lung-infection) or may have only a mild pneumonia and only 15% develop more serious respiratory symptoms needing hospitalization and assisted breathing support and only 5% become critical with respiratory failure, shock and or multi organ failure.
Who are the people at high risk? It is to be remembered that the virus is highly infective and all are equally susceptible to the infection. It is the severity of the disease and the complications that varies amongst subsets. The ones who are at risk for more severe disease, complications and a poorer outcome are people with poor immunity, the malnourished, elderly and frail, patients on long-term steroids and other immuno-suppressive drugs as liver, kidney and heart transplant patients.
COVID-19 and the heart: The primary damage to the heart results from the lack of oxygen supply to the heart which causes a progressive failure in the pumping function of the heart. Added to this insult, the sudden chemical storm can cause a fall in the blood pressure which further reduces the blood and oxygen supply to the heart, thus creating a vicious cycle of increasing damage. The brain when it senses this poor pumping efficiency of the heart, in order to maintain adequate oxygen supply to the organs causes an increase in the heart-rate. This helps initially, but then the heart starts failing like a repeatedly flogged horse does, to a point when it cannot cope up further and a cardiac arrest ensues.
People with heart ailments are not especially prone for COVID-19 and their risk to get the infection is the same as any healthy person. However, patients with heart diseases can have more severe complications when they get COVID, especially those with previous heart-attacks, heart failure, children with certain cardiac birth defects (blue-baby defects) to mention a few. Pregnant women who have heart ailments may be at a higher risk too. However there is no evidence that the virus can infect implanted heart-devices like pacemakers or defibrillators or that it can directly infect the valves, muscle or the covering of the heart. However it is important to note that the stress on the heart produced by the chemical storm may cause rupture of fatty plaques or blocks inside the arteries of the heart and can cause a heart-attack.
Another point of controversy and debate is regarding two medications used commonly to treat high blood-pressure (Angiotensin converting enzyme inhibitors and Angiotensin II receptor blockers) which block ACE-2 and its system through which the virus enters the body. It was of concern that people taking these medications could develop more lung complications with COVID-19. However these observations have no confirmatory scientific evidence and major guideline forming cardiology societies and associations like the American Heart Association, European Society of Cardiology, and British Cardiac Society have recommended that these drugs should not be stopped, because these are drugs with proven benefits. Stopping cardiac medications without advice from the cardiologist can only lead to complications.
How deadly is COVID-19? Thankfully, majority of the patients recover. The death rate from COVID 19 is estimated to be 1.4% (which for flu is only 0.1%). The fatality increases with increasing age being less than 1% for people less than 50 years 1.3% for 50 to 60 years, 3.6% for 60 – 70 years, 8% for 70 – 80 years and 15% for those above 80 years of age. Also death occurred only in 0.9% of the patients when there was no associated illnesses but it was 6 – 10% when the patients had associated high blood pressure, diabetes and other cardiac conditions. The reason or mechanism as to why patients with high blood pressure have higher death rates is unclear but could mostly be only an apparent association because of the higher prevalence of high blood pressure in elderly age group (> 70 years of age) which had maximum deaths.
Diagnosis of COVID-19: Testing for COVID specifically relies mainly on three tests, the real time reverse transcription-polymerase chain reaction (RT-PCR) which is the gold-standard for SARS-CoV -2 viral genetic material, the antigen test which detects viral surface proteins (eg: spike protein) and the third being antibody (immunoglobulin) testing. RT-PCR and antigen tests use specimens collected from the respiratory tract secretions of the patient. All the tests are useful in different stages of the infection as their titres are variable with the duration of infection, viral load and severity of symptoms. False positive results can occur with antigen testing and false negative tests can occur if the specimen collection is improper. Therefore a negative test should be repeated in a patient in whom the clinical index of suspicion for COVID is high.
Antibodies are produced by blood cells called lymphocytes, specifically against the virus and the antibodies bind tightly to the virus to inactivate it. Antibody levels start rising with time as the body tries to fight the infection and blood samples are used for detection of these. The immunoglobulin (Ig) M antibodies are the first to be produced in response to the infection and Ig G starts rising a week to 10 days after onset of infection and remains in the blood even after the patient has recovered and is the one that indicates possible immunity from subsequent infections. But it is too early to say how much immunity would be conferred by Ig G antibodies against COVID-19.
Treatment of COVID-19: Currently, the treatment is mainly supportive like ensuring control of fever, maintaining good hydration and nutrition and it is only when the oxygen content of the blood drops, the blood-pressure drops or the patient gets worse that hospitalization is advocated. Several drugs currently used against the virus are those targeted against the different mechanisms of virus multiplication and the chemical storm. An effective treatment or cure in the form of medications can only be obtained by a detailed understanding of the pathology of the disease obtained from post-mortem studies and a deep understanding of the microbiology of this novel virus, the pathogenesis and immunology of the disease and use of medications directed at every possible step. Until the recent evidence with the drug Remdesivir, there was no definitive success with the use of any specific drugs against the virus. All medications being used were merely on an experimental basis. However, Remdesivir an anti-viral drug which prevents multiplication of the virus in the body has been shown in a multi-centre randomized controlled trial to have clear-cut evidence in hastening the recovery of patients being treated with it. The use of Remdesivir has now been made ‘standard of care’ in the treatment of patients hospitalized with COVID-19.
Some of the other drugs being used in COVID-19 patients with variable results are those which would prevent virus entry into the cell (chloroquine) or to treat cytokine storm (Tocilizumab). Drugs like chloroquine and hydroxychloroquine have only been tested outside the human body to show some efficacy and there are no randomized controlled trials to prove its efficacy in humans with certainty. It is important however to remember that some of the drugs have cardiac side effects and can cause electrical abnormalities called ‘torsades de pointes’ which can cause sudden cardiac death and therefore needs electrocardiogram (ECG) monitoring and should not be taken without consulting a specialist.
Treatment with convalescent plasma is another option being investigated and attempted. It involves the transfusion of plasma obtained from recovered patients, containing high titres of antibodies against SARS Co V- 2, into other patients who have less severe infection or patients who are in early stages of the infection or people who are at high risk of getting COVID, as health-care professionals. The antibodies present will prevent multiplication of the virus in the body and thus prevent lung and other organ damage. However this procedure is not totally risk free to the person receiving the treatment and have a risk of transmitting other infections and causing other immune reactions.
Prevention is better than cure: As of now with no cure in hand, prevention is the key and the steps to prevention are simple and involves avoiding touching the mouth, nose and eyes with unclean hands, washing hands thoroughly with soap and water for at least twenty seconds or the use of hand-sanitizers containing at least 60% alcohol. It is also important to keep frequently touched objects clean with disinfectants. Practicing social distancing or maintaining a safe distance of at least two metres from other people whenever possible and keeping away from sick people even if their symptoms are mild and also staying away from crowded areas is vital. Also covering one’s nose and mouth with a cloth or with the inside of the elbow when one sneezes or coughs and using the non-dominant hand to touch objects so that you would not unknowingly use it to touch your mouth nose or eyes are good practices. Wearing the right protective masks in public places is crucial and only masks which are recommended for COVID-19 protection will be protective and have to be used in the right manner and will be useful in public places where the chances of getting infected are high.
If one experiences fever, cough or chest infection it is important to consult a doctor on the phone and follow his instructions and get tested only after taking professional advice as testing centres can be potential areas of high infectivity.
Vaccines and immunity: Vaccines are being researched on fervently but would take a while to be available for human use, after they are tested in animals and proven to be effective and safe. After the first infection, it is speculated that COVID 19 would confer immunity but if mutations and fresh strains occur, they could re-infect, and would need fresh vaccines, information about which is currently unavailable. Herd immunity is a concept where, when a large percentage of the population are infected and recover and get immunity, thereby providing protection in a community, where the chances of non-immune people getting infected are less because the percentage of infected carriers in that community steadily becomes fewer.
Thus, the COVID-19 has taken an erstwhile head-strong and free world unawares, with a chilling shock, sending them into hiding, when an invisible nothing has humbled seemingly invincible powers and the powerful of the world, putting medical researchers and organizations on their toes desperately trying to find a quick resolve, while the front-liners strive tirelessly risking their own lives to save humanity from a rapidly decimating disease. Adding to the cost of life, the economic repercussions would be severe too.
This infliction of unimaginable proportions has also given humanity an opportunity to introspect on the wrongs we have committed, when we abused nature with all our power and glory; has given us a time to introspect on what we did wrong as a world and as individuals when we divided ourselves with borders, languages, colour, religions, caste and what not; when now, standing together singularly as humanity with humaneness seems to be the only way to tide over this catastrophe of unfathomable proportions. Let us change for the better, but then will we be given that chance? Hope and faith is what has always kept the world going and so may God bless us all!
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As Australia has witnessed a serious spike in Covid-19 cases
in the recent past, the country has temporarily closed its border between Victoria
and New South Wales, the two populous states in the country.
Melbourne, the capital of the Australian state of Victoria
has witnessed hundreds of Covid-19 cases in the recent past.
The border between the two states was open, though the movement
between these two states and other states was restricted.
It is the spike in the number of cases that has promoted the
country to go this far – to impose a serious restriction.
The restriction means the travel between these two states will
be restricted until the government decides otherwise.
As per a latest report, the decision to impose the restriction has been taken jointly by the central leadership and the state leadership.
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