Indians may have a better chance of surviving the coronavirus disease (COVID-19). India’s herd-based immunity is due to extensive microbial load. General exposure to a variety of pathogens makes them immunologically strong and they are not susceptible to infection as much as other populations, said Dr Swati Rajagopal, consultant, infectious disease & travel medicine, Aster CMI Hospital.
Moreover, turmeric used in Indian dishes has anti-oxidant, anti-inflammatory, anti-bacterial and wound healing properties that boost the immune system. Even the effect of India’s temperature and humidity is widely discussed, she added.
“Our population has a general exposure to variety of pathogens which could immunologically make them strong and are not susceptible to infections as much as other populations. They have a broad spectrum and cross reactive T-cell immunity. But the role of BCG vaccine is still being reviewed,” Dr Rajagopal told Pharmabiz.
There is also a high genetic diversity is observed in India. An important part of the immune system is the HLA (human leukocyte antigen) class 2 haplotype which are associated with the disease. The remarkable diversity of the HLA-DR3+ve autoimmunity favoring haplotypes in Indian population is seen to have a significant survival advantage. This diversity could enhance the probability of selecting HLA molecules with more efficient binding specificities to the SARS- COV2 peptides and could compromise the replication of the virus. This would mean that the genetic diversity could confer the Indian population with the ability to adapt to the SARS COV2 peptides to initiate the immune response and control the mutations and lead to compromised replication, she noted.
Epidemiologically though more studies and work are required, it appears that Indians may have a better chance of surviving the virus. But, it is still important that we keep the viral loads under check - that was the purpose of the lockdown. The possibility of developing herd immunity is being considered : However , we still need to remain safe - continue the steps of hand hygiene , masks and physical distancing as limited information is available on above data and we do not have standardized treatment strategies yet, said Dr Rajagopal.
Though there are several drugs associated with the disease which can be potential components for COVID-19 treatment, they are still in the investigation stage. But none of these are approved as the drug for the disease. Even hydroxychloroquine (HCQ) and azithromycin which had shown promise earlier on, now appear to have doubtful efficacy. Favipiravir is again an investigational drug under trial and has been recently approved for human studies in India. IL6 inhibitors shows some promising data and tocilizumab can be taken under consideration. With recent trials, we may need to consider convalescent plasma and remdesivir. While COVID-19 management protocols are dynamic and evolving, it is for the government and private hospitals to follow the same standard of care, said Dr Rajagopal.