Inter nation social lockdown versus medical care against COVID-19, a mild environmental insight with special reference to India

Abstract

Infection by coronavirus (CoV-19) has led to emergence of a pandemic called as Coronavirus Disease (COVID-19) that has so far affected about 210 countries. The dynamic data indicate that the pandemic by CoV-19 so far has infected 2,403,963 individuals, and among these 624,698 have recovered while, it has been fatal for 165,229. Without much experience, currently, the medicines that are clinically being evaluated for COVID-19 include chloroquine, hydroxychloroquine, azithromycin, tocilizumab, lopinavir, ritonavir, tocilizumab and corticosteroids. Therefore, countries such as Italy, USA, Spain and France with the most advanced health care system are partially successful to control CoV-19 infection. India being the 2nd largest populous country, where, the healthcare system is underdeveloped, major portion of population follow unhygienic lifestyle, is able to restrict the rate of both infection and death of its citizens from COVID-19. India has followed an early and a very strict social distancing by lockdown and has issued advisory to clean hands regularly by soap and/or by alcohol based sterilizers. Rolling data on the global index of the CoV infection is 13,306, and the index of some countries such as USA (66,148), Italy (175,055), Spain (210,126), France (83,363) and Switzerland (262,122) is high. The index of India has remained very low (161) so far, mainly due to early implementation of social lockdown, social distancing, and sanitizing hands. However, articles on social lockdown as a preventive measure against COVID-19 in PubMed are scanty. It has been observed that social lockdown has also drastic impacts on the environment especially on reduction of NO₂ and CO₂ emission. Slow infection rate under strict social distancing will offer time to researchers to come up with exact medicines/vaccines against CoV-19. Therefore, it is concluded that stringent social distancing via lockdown is highly important to control COVID-19 and also to contribute for self-regeneration of nature.

Keywords: COVID-19; Clinical management; Environmental effect; Pandemic; Social distancing; Social lockdown.

Graphical abstract

Fig. 1

Confirmed cases of COVID 19 positive cases worldwide. The intensity of color indicates number of affected people per 1 million people in world as of now on 02.04.2020 (Source https://google.com/covid19-map/?hl=en), b.-numerical values for the total number of cases in C-19 as on 04.03.2020.

Fig. 2

A typical figure of COVID-19. White arrows indicate its receptors protein on its surface and the red arrows indicate the envelop protein. b) A single stranded RNA is enclosed by envelop protein layer (modified after Scripps Research Institute (89)).

Fig. 3

Death rate of patients as a function of age. Analyses of the data till 05.04.2020 indicates that elderly patients are with a high risk of death under COVID-19 infection, while, young and children are not totally safe (CDC, 2020).

Fig. 4

Number of beds available nation wise in respective years. India lags behind the far in the list and joins among counties such as Afghanistan, Bangladesh, Cambodia, Ethiopia, Ghana, Guinea, Madagaskar, Mozambique, Nigeria, Pakistan, Sudan, Uganda and Yemen. Data are as per the latest updates on 06.04. 2002 in Word Bank website.

Fig. 5

Status of COVID-19 pandemic in India (Data obtained from the Ministry of Health & Family Welfare, Government of India, New Delhi). a) Although the first positive case was started in 1st January 2020, the rate of increase of the pandemic was not that much high I comparison to the other developed counties. The number of confirmed cases has gained a sharp increase from 9th March 2020 to 5th April 2020, but the number remained within hundreds up to 28th March and with 4000 up to 5th April 2020. It shows a great control over the disease. Similarly, recoveries and death rate were very slow limiting within 100, indicating a positive aspect in favor of control of the disease. b) The percentage of increase of the infection, recoveries death case was very slow and the graph have showed different spikes but overall a steady stable growth indicating a strong grip of the federal government of India over the diseases.

Fig. 6

Major economic associated change in three main cities of India. Data are as per the daily foot prints in terms of walk-ins from Goole India data (in first week of lockdown) to the respective sectors in first week of lockdown. The average changeover of foot prints (%) are represented in Delhi, Mumbai, Bengaluru and Chennai for a) banking and petrol pump sector, b) grocery shops and in c)diagnostic centres (sources Livemint (60)). Reproduced under a creative commons license (60).

Fig. 7

Propagation of CoV-19 in host cells via S protein that binds ACE2. a)After S binds to ACE2, the conformation change in the S protein to cleave it into S1 and S2 proteins that facilitates viral envelope fusion with the cell membrane through the endosomal pathway. Then CoV-19 releases RNA into the host cell and its RNA is translated into viral replicase polyproteins pp1a and 1ab, which are then cleaved into small products by viral proteinases. The polymerase produces a series of sub-genomic mRNAs by discontinuous transcription and at the end, translated into relevant viral proteins. Viral proteins and genome RNA are subsequently assembled into virions in the ER and Golgi and then transported via vesicles and released out of the cell. ACE2, angiotensin-converting enzyme 2; ER, endoplasmic reticulum; ERGIC, ER–Golgi intermediate compartment (reproduced from Shereen et al. (2020) under a Creative Commons license). b) Different stages of growth and propagation of COVID-19 in human lungs (reproduced from Li et al. (2020b) under a creative commons license).

Fig. 8

A cartoon showing the management of COVID-19 with the advisable medicines or preventive measures by social distancing. “X” symbol indicates the prevention the disease and “+” indicates the additional effort required along with social distancing to prevent the disease. Immuno-modulating life style by changing food habit, exercise etc. may be adapted.