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2021|Vol
.4|I
ssueNo.
1
04 January 2021 | Vol.4 |#01
NEWS BULLETIN A weekly publication from NIRT Library
Covishield vs Covaxin
Sci-Hub Case: The Court Should Protect
against Covid-19: All you
Science From Greedy Academic
need to know
Publishers
22/DEC/2020 With more than one vaccine now
approved for emergency use, the
A court of law in India shouldn't allow itself to become a tool
scope of India’s first phase
for perpetuating inequalities in access to scientific literature in
vaccination in which the frontline
the developing world.
workers will be vaccinated at free of
cost gets widened.
Updated: Jan 03, 2021, 20:33 IST
The Drug Controller General of India
on Sunday gave the final approval to
two vaccines against Covid-19 for
restricted emergency use. With this, it
can be expected that the
vaccination drive in India will begin
Not many litigations have evoked strong, even panicky, soon. All states and union territories
reactions from researchers in natural sciences in India – but a have already conducted dry run of
copyright infringement suit filed by three publishing giants vaccines. With more than one
against Sci-Hub and Libgen before the Delhi High Court on vaccine now approved for
December 21, 2020, has managed to do just that. The three emergency use, the scope of India’s
are Elsevier, Wiley and American Chemical Society. Reactions first phase vaccination in which the
to the ‘development’ ranged from wondering whether Sci-Hub frontline workers will be vaccinated at
will be banned in India to whether it is advisable for researchers free of cost gets widened.
to intervene in this litigation, to share their perspectives.
Here is all you need to know about
In fact, researchers at all levels have expressed concern – from
these two vaccines: …..
undergraduate students who may have to write term papers
to senior professors whose future research is at stake. And the
Continued in page no.27
reactions are not surprising: the Delhi high court completely blocked in India through a so-called
now has the duty to determine the future of dynamic injunction. The publishers claim that
access to scientific literature in India. The first they own exclusive rights to the manuscripts they
hearing is set for December 24. have published, and that Sci-Hub and Libgen
are engaged in violating various exclusive rights
The facts of the case conferred on them under copyright law by
providing free access to their copyrighted
There are four plaintiffs in this case. contents.
The first is the publication giant Elsevier, which The publishers also contend that Sci-Hub and
publishes more than 2,500 journals, including The Libgen have created – and continue to create –
Lancet. As is evident from the statements in the numerous domains on the web so they can
suit, ScienceDirect, the proprietary database provide access to articles or book chapters
through which Elsevier generally provides access published by the plaintiffs, even if some of their
to their journal contents, acts as a toll-gate to a domains have been blocked by court orders in
quarter of the world’s peer-reviewed, full-text other countries.
scientific, technical and medical literature.
They have also added ISPs as defendants
The second and third petitioners are Wiley India because the details of those working to maintain
Pvt. Ltd. and Wiley Periodicals Pvt. Ltd., and Sci-Hub and Libgen aren’t fully accessible,
together they represent the publication giant except that of Elbakyan, and to ensure the
Wiley. According to the suit, Wiley publishes contents of the domains are blocked. DoT and
more than 2 lakh articles every year in over 1,700 MeitY have been made parties to the litigation
journals. to ensure they notify the ISPs and telecom
providers to block access.
The fourth plaintiff is the American Chemical
Society, which publishes more than 60 journals. Relying on a previous judgment of the Delhi high
More than 2,000 articles are published annually court, i.e. UTV Software Communication Ltd. v.
in its Journal of American Chemical 1337X.to and Others, which dealt with websites
Society alone. providing access to copyrighted movies, the
publishers are demanding that the court issue a
The first defendant in the case is Alexandra dynamic injunction. That is, once a defendant’s
Elbakyan, the founder of Sci-Hub. The second is website is categorised as a “rogue website”, the
Libgen, which provides free access to ebooks. plaintiff won’t have to go back to the judges to
Defendants 3 to 11 are various internet services have any new domains blocked for sharing the
providers (ISPs) in India. Defendant 12 is the same materials, and can simply get the
Department of Telecom (DoT) and #13 is the injunction order extended with a request to the
Ministry of Electronics and Information court’s deputy registrar.
Technology (MeitY).
The problem
Now, if the Delhi high court issues a dynamic
injunction against Sci-Hub and Libgen, the vast
Alexandra Elbakyan. majority of researchers in India may not be able
Photo: Sci-Hub
to access peer-reviewed articles and book
chapters vital for their research and education,
In a nutshell, the publishing giants are
via these two platforms. The progress of science
demanding that Sci-Hub and Libgen be
depends on access to existing literature; the
denial of such access can also result in serious The COVID-19 pandemic has also illustrated how
social, economic and public health tragedies. there can be situations in which researchers
won’t be able to visit their campus to access
For example, without access to the latest materials. So even if a researcher’s institution
literature, how will healthcare professionals learn may have an institutional subscription to a given
about the latest developments in any medical journal, the researcher may in practice not be
field? Thanks to the manner in which publication able to access the material using this
giants have been controlling access to peer- subscription.
reviewed scientific literature today, most of it
languishes behind paywalls that require Both Sci-Hub and Libgen have been trying to
hundreds to lakhs of rupees to unlock. The price address the problems of inequality in access
for 24-hour access to one article (‘Oral through a revolutionary approach: by liberating
rimegepant for preventive treatment of access to the millions of manuscripts unjustifiably
migraine: a phase 2/3, randomised, double-blind, controlled by publishing giants. While one may
placebo-controlled trial’) published in the latest agree or not on their approach, we can’t ignore
issue of The Lancet, is $31.50 – approximately Rs the practical demands of research and the
2,330 – nearly a hundred rupees an hour! inequality in access constantly that researchers
How many doctors and researchers in India’s from the Global South constantly have to deal
numerous public healthcare facilities and with. And when a court has to deal with the issue
universities will be able to access all the relevant of granting an injunction, it shouldn’t ignore the
literature in this pricing model? Publishers may context in which both Sci-Hub and Libgen have
argue that their primary consumers are emerged as counter-movements against the
institutions, not individuals, but it’s notable that propertisation of scientific communication.
even institutional subscriptions are not without
severe restrictions on access beyond campus.
NIRT Library News Bulletin
3
Second: when a court decides on an injunction court’s deputy registrar. Such an approach takes
application, it needs to follow certain basic away a very desirable critical, judicial
principles. In a landmark case before the US examination on a matter as important as
Supreme Court – eBay Inc. v. MercExchange, blocking websites/webpages.
L.L.C. – the court reiterated the need to use the
traditional four-factor test that courts apply. To Finally, if one looks at the plaint, it should be
get a permanent injunction, a plaintiff has to obvious that the publishers are only providing an
demonstrate the following: illustrative list of copyrighted materials shared via
Sci-Hub and Libgen. Note also that not all
1. The Plaintiff has suffered an irreparable injury; materials currently available on Sci-Hub or
Libgen might be copyright-infringing. In some of
2. Remedies available at law are inadequate to these works, copyright might have expired; in
compensate for that injury; some others, a publisher could be wrongly
asserting copyright. So until a court of law
3. That considering the balance of hardships determines with a proper trial whether all of Sci-
between the plaintiff and defendant, a remedy Hub’s contents are copyright-infringing, we
in equity is warranted; and can’t jump to any conclusions.
4. The public interest would not be disserved by So we need a proper trial to determine whether
a permanent injunction. the plaintiffs’ claims extend to all the materials
they have made available, and to analyse
If we applied these factors to the current context, whether the defendants can claim benefit of
it would seem that a permanent injunction any of the limitations and exceptions provided
shouldn’t be granted, as doing so would disserve under copyright law.
the public interest.
Many copyright scholars around the world still
Third: we ought to critically reexamine the UTV cite the judgments of the single bench and the
software decision, which the plaintiffs relied on in division bench of the Delhi high court in the Delhi
their demand for a dynamic injunction. Dynamic University photocopy shop case as judgments
injunctions provide an extremely broad remedy that considered the practicalities of education in
to IP owners without adequate judicial scrutiny, India, and provided a balanced solution that
and they can have severe negative effects on doesn’t unduly affect the authors’ incentives.
diverse fundamental rights, including free
speech. Any injunction should be limited to the In this regard, a dynamic injunction against Sci-
specific links provided by the plaintiffs in their Hub and Libgen could result in long-term harm to
petitions and they should under no science in India and distort the fine balance
circumstances be extended to a complete within the copyright system. A court of law in
website or new domains without adequate India shouldn’t allow itself to become a tool for
judicial scrutiny. perpetuating inequalities in access to scientific
literature in the developing world. Let the current
In the UTV software decision, the power to order
copyright infringement dispute be decided
blocking of websites “on being satisfied that the
through a fair trial that deliberate the issues in a
impugned website is indeed a
more holistic manner.
mirror/redirect/alphanumeric website of
injuncted Rogue Website(s) and merely provides
Arul George Scaria is an associate professor of
new means of accessing the same primary
law and co-director of the Centre for Innovation,
infringing website” was conferred on the high
NIRT Library News Bulletin
4
Intellectual Property and Competition (CIIPC), 9,619 suspected cases with persistent cough and
National Law University, Delhi. He is also an weight loss. Of them, 499 came positive for TB after
affiliate faculty member of the CopyrightX test. Dr Pranita Tipre, in-charge of TB in the
program of Harvard Law School. His key areas of Brihanmumbai Municipal Corporation (BMC),
interest and specialisation are science and said: “From diagnosing 4,500-5,000 new TB cases
technology policies, open movements, every month, Mumbai’s TB notification fell very low
intellectual property law and competition law. from March to June. People were afraid to come
forward and get tested in a clinic due to
the pandemic.” She added that before March,
active door-to-door screening yielded very few
numbers, but this time, detection of 499 cases was
very high. “This shows that finding active cases will
help detect the hidden ones as people are still
scared to get tested. In the past few months, we
9,206 TB cases found in diagnosed 2,500-3,000 cases. We are improving
but there is scope to do more.”
Maharashtra after month-long
drive BMC officials said they feared several TB patients
could be deprived of medication owing to
Total 8.66 crore people, including 6.82 crore in lockdown. In the lockdown months, civic officials
rural and 1.84 in urban areas, were screened visited local communities to disburse one to two
during the state-run drive months of medicines to several patients.
Written by Tabassum Barnagarwala | Mumbai | Updated: Tuberculosis and leprosy are both highly infectious
January 2, 2021 1:59:26 pm diseases that can fast manifest among those with
poor immunity. The TB notification had dropped
Following a month-long drive, the Maharashtra
significantly during the pandemic picking up only
government has detected at least 9,206 new
slightly from September after state machinery
tuberculosis (TB) cases in the state. The maximum
reactivated all health programmes. Between
cases were detected in Thane (988), Pune (647)
March to July, 51,884 TB cases were detected, a
and Ahmednagar (539).
dip of 44 per cent from 2019 when 93,253 cases
were diagnosed in the same period.
The state government began door-to-door
screening to detect leprosy and TB cases on
In the month-long drive in December, Thane (988)
December 1. A target to screen 8.66 crore
recorded the maximum TB cases, followed by
population, including 6.82 crore in rural areas and
Pune (647), Ahmednagar (539), Mumbai (499)
1.84 in urban municipal corporations, was set.
and Jalgaon (461).
A team of two health workers, including ASHA or
Fourteen districts recorded between 200-400
anganwadi staff, visited 20 households in rural and
cases during the screening drive. Districts like
25 in urban areas each day. The health workers
Washim, Parbhani and Sindhudurg recorded less
collected two sputum samples from the
than 100 TB cases.
suspected cases, while the confirmed cases were
asked to undergo chest X-ray.
Dr Ramji Adkekar said the detection of new cases
In Mumbai, 49.88 lakh people in slums and high-
and their treatment will help arrest further
risk areas were screened. Civic officials found
transmission in community. All these cases have
NIRT Library News Bulletin
5
been put on treatment, he said. The state is yet to In the case of the variant first reported in UK,
check which of the newly diagnosed patients named lineage B.1.1.7, there is an unusually large
have drug-resistant tuberculosis. divergence from its nearest ancestor, suggesting
that it may have come from a person with a
prolonged infection. These new mutations seem
to have enabled it to spread more effectively.
While measures such as hand-washing, distancing
and masks will remain effective, increased
transmission rate could be devastating in
countries where the infection is exponentially
increasing and the health systems are under
India needs a national pressure. So far, this variant has not been
surveillance plan associated with more severe disease or higher risk
of death.
With our massive population, over 10 million known
cases, and undiagnosed cases probably We also do not expect this variant to be able to
numbering over twenty times that, India may well evade immunity induced by either previous
be the place for the next important variant to infection or vaccines since this is typically due to
emerge. Going forward, we need as much recognition of multiple sites by antibodies as well
caution within India, as for incoming international as by immune cells. Therefore, based on available
travellers. data, I do not see the B.1.1.7 variant as a major
OPINION | Updated: Dec 28, 2020, 22:01 IST worry for India right now. But any increase in
severity or reduction in immunity still needs to be
carefully monitored, and rapid spreading in itself
can increase avoidable deaths if health care
systems get overwhelmed by numbers.
Mass-scale production of generic drugs and
vaccines was always our strength. The year 2020
has additionally seen India become more
“atmanirbhar” in areas ranging from diagnostics
to devices. The recent procurement by the Delhi
government of over a thousand Swasth-Vayu
non-invasive BiPAP ventilators, indigenously
The announcement of a new rapidly spreading developed at the CSIR National Aeronautical
mutated variant of the Sars-CoV2 virus in the Laboratory, would have been difficult to imagine
United Kingdom (UK) has been followed by a in 2019. Innovative diagnostics are also gaining
variety of reactions. It was always likely that a traction. For example, we expect to be able to
mutated Sars-CoV2 variant may emerge that is rapidly modify the CRISPR-based Sars-CoV2 test
worse. While it is in UK... (Feluda) to discriminate the UK variant, if it is
clinically required going forward. Thus, I expect
eliminate the virus, the more such mutations may any B.1.1.7 or related outbreak in India to be
accumulate. If such mutations become beneficial containable and in the worst case scenario,
for virus survival and propagation from human to manageable.
human, they can rapidly spread in the
community.
NIRT Library News Bulletin
6
Despite my conviction that we are well- placed to not only positive or negative, but also the strain,
weather the current storm, complacence must be within the same day. We have also used larger
avoided. We should continue doing what we machines to affordably sequence more than a
have already done well, and also prepare 1,000 samples in a single run, which can be part of
ourselves for new twists and turns in this pandemic, mega-lab national hubs serving lakhs. Using these
as well as for future ones. technologies, we can ask questions limited not
only to Sars-CoV2, but for any known organism
A good start is to appreciate the molecular and e.g. for tuberculosis, as well as interrogate
epidemiological surveillance efforts by UK that unknown ones such as a potential future
have led us to know about this variant in a timely pathogen. What is now required is a national
manner; hopefully early enough to limit its global surveillance plan of current and future
spread. In India, Kerala and CSIR-IGIB have pandemics, building capacity and preparedness.
already conducted similar studies and some other In the spirit of never wasting a good crisis, let us use
states had also expressed interest. Rapidly scaling the current public attention as a catalyst for
up such capacity across India is achievable change.
through national coordination; scientifically we Anurag Agrawal is director of CSIR Institute of Genomics
are ready. This would help to not only to discover and Integrative Biology.
The views expressed are personal.
and limit spread of this variant, but also any future
ones. After all, the virus mutates inside people.
With our massive population, over 10 million known
cases, and undiagnosed cases probably
numbering over twenty times that, India may well
be the place for the next important variant to
emerge. Going forward, we need as much
caution within India, as for incoming international Some who recover from Covid get
travellers.
debilitating spine infection: Mumbai
So how do we maintain surveillance of Sars-CoV2 doctors
and future pandemics? Regarding the
TNN | Dec 29, 2020, 08.17 AM IST
emergence of worrisome strains or new
pathogens, it is really not a question of whether,
MUMBAI: While post-Covid syndrome is a well-
but when. Scientists had previously warned of a known entity in which some patients continue to
future pandemic based on identification of
experience Covid-like symptoms for months, city
coronaviruses similar to Sars-CoV2, in China.
doctors have now noticed a debilitating spine
Hopefully, we will do better in future.
infection in some elderly patients hospitalized for
the viral fever. At Nanavati Hospital in Juhu, six
Large scale sequencing is now easier than ever elderly patients with spine infection or abscess
before. We have successfully used sequencers were treated in four weeks. “They needed
(devices that can determine the sequence of hospitalization for weeks during their Covid-19
DNA/RNA) that are as small as a pencil box and infection,’’ said spine surgeon Dr Mihir Bapat. The
cost less than a high-end television, to sequence infection was so severe that five needed spine
over a 1,000 Sars-CoV2 genomes at costs surgery plus last-resort antibiotics. “They will take
comparable to what an RT-PCR used to be in three months to move around normally,’’ said Dr
March 2020. These can become micro-labs that Bapat.
can take sequencing to point of care diagnostics,
such that you sequence the sample to determine
NIRT Library News Bulletin
7
For Vasai resident Renold Sirwel, medical bills since (between vertebral wall and membrane). “At
he contracted Covid in September were above Fortis, a patient, after Covid developed an
Rs 15 lakh. The 68-yearold has had four abscess in the area outside the spine,’’ he said.
hospitalisations, a spine surgery and a nurse
comes home thrice a day to administer IV The doctors said there was a need to suspect
antibiotics that cost Rs7,000 daily. spinal infections early. “If a recovered Covid
patient has back pain that does not improve after
“My father never fell ill and would walk 10km daily bed rest for at least two weeks, further
till he got Covid,’’ said his son Vinit. investigations are needed,’’ said Dr Bapat.
He was admitted to a local hospital for 10 days
and got remdesivir for treatment. Within few days
of returning home, he was rushed again to
hospital with excruciating lower back pain. Over
the next two months, he visited doctors as his pain
worsened and started treatment for spine As virus resurges in Africa,
tuberculosis.
doctors fear the worst is yet to
He was referred to Dr Bapat and a spinal biopsy
come
showed gram-negative bacteria found only in
BySheri Fink | Last Updated: Dec 26, 2020, 11.19AM IST
hospital ICUs. Sirwel, who underwent spine
operation at Nanavati on December 7 and was Synopsis
discharged a fortnight later, has to take last-resort When the pandemic began, global public health
antibiotics such as colistin and tigecycline for officials raised grave concerns about the
three weeks. vulnerabilities of Africa. But its countries overall
appeared to fare far better than those in Europe or
While the Sirwels wonder what led to the spine the Americas, upending scientists’ expectations.
infection, doctors state it is not a Covid-related Now, the coronavirus is on the rise again in swaths of
infection. “It is possibly related to low immunity the continent, posing a new, possibly deadlier threat.
Covid patients have,’’ said Dr Bapat.
PORT ELIZABETH, South Africa: At the center of a
Another spine surgeon, Dr Samir Dalvie from terrifying coronavirus surge, 242 patients lay in row
Hinduja Hospital, Mahim, also saw cases of spine after row of beds under the soaring metal beams
abscesses in patients who recovered from Covid. of a ecommissioned Volkswagen factory.
“Covid affects the body’s ability to fight infections
that could have been latent and flare up,’’ he Workers at the vast field hospital could provide
said. oxygen and medications, but there were no
intensive care unit beds, no ventilators, no working
Another doctor said as the spine infections are
caused by micro-organisms found only in hospital phones and just one physician on duty on a
recent Sunday — Dr. Jessica Du Preez, in her
ICUs, it means the patient got it during his initial second year of independent practice.
hospital stay for Covid treatment.
In a shed-like refrigerator behind a door marked
Dr Rahul Pandit, ICU head of Fortis Hospital and a “BODY HOLD,” carts contained the remains of
member of the state task-force on Covid, said three patients that morning. A funeral home had
microbes fester in the spine epidural space already picked up another body.
NIRT Library News Bulletin
8
When the pandemic began, global public health
oicials raised grave concerns about the
vulnerabilities of Africa. But its countries overall
appeared to fare far better than those in Europe
or the Americas, upending scientists’ expectations.
Now, the coronavirus is on the rise again in swaths
of the continent, posing a new, possibly deadlier
threat.
In South Africa, a crush of new cases that spread
from Port Elizabeth is growing exponentially across
the nation, with deaths mounting. Eight countries,
including Nigeria, Uganda and Mali, recently
New York TimesMahad Yusuf Kahlye, who works 12-hour shifts recorded their highest daily case counts all year.
tending to COVID patients' oxygen tanks at De Martino “The second wave is here,” John N. Nkengasong,
hospital in Mogadishu, Somalia. the head of the Africa Centers for Disease Control
and Prevention, has declared.
On rounds, Du Preez stopped at the bed of a 60-
year-old patient, a grandmother and former When the virus was rst detected, many African
college counselor. Her oxygen tube had countries were considered particularly at risk
detached while she was lying prone, but the because they had weak medical, laboratory and
nurses had so many patients they hadn’t noticed. disease-surveillance systems and were already
Now, she was gone. battling other contagions. Some were riven by
armed conict, limiting health workers’ access. In
As two porters placed her corpse in a bag, a
March, Tedros Adhanom Ghebreyesus, the rst
worker peeked through the door to tell them
African directorgeneral of the orld Health
another patient, a 67-year-old diabetic man, had
Organization, cautioned, “We have to prepare for
died.
the worst.”
Meanwhile, the condition of a teacher in her 50s
But many African governments pursued swift,
was deteriorating. Du Preez tried to nd ICU space
severe lockdowns that — while nancially ruinous,
for her elsewhere in the city, to no avail. She called
especially for their poorest citizens — slowed the
the teacher’s husband, who asked what he could
rate of infection. Some deployed networks of
do. “Not much,” the young doctor responded.
community health workers. The Africa CDC, the
WHO and other agencies helped expand testing
“Shame,” she said again and again that day.
and moved in protective gear, medical
For hours, the alarm on the teacher’s bedside equipment and pharmaceuticals.
monitor bleated. Her oxygen level was
The reported toll of the pandemic on the
dangerously low, her pulse racing and her blood
continent — 2.6 million cases and 61,000 deaths,
pressure soaring. Still, she remained conscious,
according to the Africa CDC — is lower than what
saying she could not breathe. That evening, she
the United States alone currently experiences in
died alone. A book, “A Heartbeat of Hope: 366
three weeks.
devotions,” lay on her bedside stand alongside a
pair of reading glasses.
But that accounting is almost certainly incomplete.
Evidence is growing that many cases were missed,
according to an analysis of new studies, visits to
NIRT Library News Bulletin
9nearly a dozen medical institutions and interviews Some Africans view COVID-19 as an aliction of
with more than 100 public health oicials, scientists, Westerners and wealthy travelers. In a classroom
government leaders and medical providers on in a Somali community displaced by drought and
the continent. war, a fourth grader readily identified the United
States as having the most cases. “Donald Trump
“It is possible and very likely that the rate of was COVID-19-positive,” he said.
exposure is much more than what has been
reported,” Nkengasong said. Sarah Oyangi, 35, an apartment complex
manager who lives in what she refers to as a slum
Now, as they battle new outbreaks, doctors are in Nairobi, said friends told her they weren’t
convinced that deaths have also gone worried because the virus “is for wazungu and the
uncounted. Dr. John Black, the only infectious- rich,” using a Swahili word meaning European or
disease specialist for adults in Port Elizabeth, said white people. “It’s not our disease.”
he and other physicians feared that many people
were dying at home. Indeed, a government Nkengasong said he was very worried about how
analysis showed that there had been more than long it would take to vaccinate enough people
twice as many excess deaths as could be on the continent to protect the most vulnerable
explained by confirmed cases in South Africa. from unwitting spreaders.
“We don’t know what the real number is,” he said.
A global effort to help low- and middle-income
Scientists are also considering other explanations countries aims for 20% coverage at most by the
for the continent’s outcome. These range from the end of 2021, one-third of what African leaders say
asymptomatic or mild infections more common in is needed. “The U.S. is not going to target 20% of
youth — the median age in Africa is just 19.7, its population. Europe is not going to target 20% of
about half that of the United States — to unproven its population,” he said. “Why do you think in
factors including preexisting immunity, patterns of Africa we should?”
mobility and climate. If those conditions helped
protect against the viruses earlier, officials ask, will The First Wave The first case on the continent was
they do to now? detected on Feb. 14 in a foreign traveler from
China to Egypt. Two weeks later, Nigeria
In South Africa, the continent’s leader by far in discovered that a contractor who had own in
coronavirus cases and deaths, the growing from Milan was ill. In South Africa, the earliest cases
devastation in its medical system has led to the involved a half-dozen or so people who had gone
rationing of care for older adults. Last week, skiing in Italy. The WHO’s regional director for
officials announced that a new variant of the virus Africa reported on March 19 that infected
that may be associated with faster transmission travelers from Europe had come into 27 or 28
has become dominant. With stricter control countries.
measures lifted and many people no longer
seeing the virus as a threat, public health officials Early on in sub-Saharan Africa, only South Africa
fear that Africa’s second wave could be far worse and Senegal had supplies to perform diagnostic
than its first. tests, but with aid, every country on the continent
was later able to do some testing.
“The risk perception has gone from something
very scary at the beginning to now something As the virus overwhelmed the West’s advanced
people are not worried about anymore,” said Dr. health systems, governments across Africa, with
Chikwe Ihekweazu, director-general of the Nigeria some notable exceptions, imposed stringent
Center for Disease Control. curfews and lockdowns. Some countries had only
NIRT Library News Bulletin
10a few cases at the time; Zimbabwe declared a outside experts. Soon, about 150 health facilities in
national disaster without having announced one. far-ung rural areas ran out of medical supplies,
and international agencies had to charter ights to
“They went into shutdown because we were keep them stocked.
terribly ill-prepared,” Nkengasong said. But that
desperate action may have put Africa ahead of The agencies also felt obliged to send ventilators,
the curve in fighting the virus, instead of behind it, costing up to $25,000 each, to poorly equipped
as the United States and Europe found themselves. countries. But Somalia, which has one of the
lowest ratios of doctors and nurses to population
South Africa shut schools, curbed travel from high- in the world, did not have enough personnel
risk countries and restricted mass gatherings. “For trained to operate them.
the rst three weeks, our epidemic was growing on
track, almost case for case, with the British That was the case with De Martino, a COVID
epidemic,” said Dr. Salim S. Abdool Karim, a top hospital in Mogadishu, which had no ICU or even
infectious-disease expert. Then “the pandemic basic fever medicine, according to its director, Dr.
just turned,” he added. “It slowed.” Abdirizak Yusuf Ahmed. Unable to secure medical
oxygen for its patients — a problem throughout
Later, the country prohibited alcohol sales, which Africa — the hospital bought tanks from an
led to a drop in car accidents, assaults and industrial supplier, built a Rube Goldberg-like
shootings, freeing up hospital capacity to treat network of pipes to the isolation wards, and
COVID patients. The police and military enforced assigned technicians to switch out empties
the measures, arresting thousands and killing around the clock.
several. In one case, soldiers found a man drinking
in a yard with a friend and allegedly beat him so Somalia exploited one advantage: a system of
severely he later died. hundreds of polio workers that extended from the
capital to remote rural areas. Employed by the
Eventually, the government eased the restrictions, WHO, they were redirected to inform people
nding the economic cost too steep. Cases soared about the pandemic and help identify cases.
and hospitals were pummeled. South Africa Community workers have detected about 40% its
brought in outside help: 200 physicians from Cuba, 4,690 known infections, according to Malik, the
medical sta from Doctors Without Borders and WHO representative.
scientists from the WHO. By late August, the
numbers dropped. But about half the country was not reporting any
cases at all. Laboratory workers fanned out; in
Roughly 3,000 miles away, and at the other end of terrain controlled by the Shabab terrorist group,
the economic spectrum, Somalia had also some were driven away. Elsewhere, they found a
imposed a lockdown. The country had a 70% high number of cases in several districts where the
poverty rate; the restrictions hit subsistence virus had never before been documented.
workers hard and also delayed childhood
vaccinations. “African countries have followed With widely varying rates of testing and data
the footsteps of all the other countries without collection across the continent, public health
understanding if it’s the best thing to do,” said Dr. officials are struggling to assess the pandemic’s
Mamunur Rahman Malik, the WHO representative reach. In more than a half-dozen countries,
in Somalia. antibody tests suggest that the virus has spread far
more widely than reported, according to research
Closed borders and canceled domestic ights involving blood donors, pregnant women, HIV-
impeded the ow of lifesaving equipment and positive people and hospital staff.
NIRT Library News Bulletin
11Many African countries are planning much lower coronavirus mortality, though a causative
broader sampling. But financial and political link has yet to be proved.
realities often cause delays. That happened in
Hargeisa, Somaliland, when health officials one To achieve widespread immunity, more targeted
recent morning debated which districts should vaccines are needed, like those now rolling out in
bear the cost of notepads, pens, pencils and the United States and Europe. Most African
cellphone airtime. countries have not struck direct deals with
Western vaccine makers, though some are
Participants also objected that some areas were importing Chinese-made vaccines not yet vetted
excluded from the survey, which they attributed by stringent regulators. The continent itself has little
to planners in Mogadishu, the capital of Somalia, vaccine-manufacturing capacity. Biovac, a
from which Somaliland declared its company in Cape Town, was trying to and a
independence in 1991 after a civil war. partner and would need up to a year to begin
filling vials.
Determining the death toll is especially
challenging. Only one-third of the nations on the But Africans have played an important role in
continent record and report annual deaths, developing coronavirus vaccines. In Durban,
according to the U.N. Economic Commission for Senzo Maloyi, 30, volunteered for a clinical trial of
Africa, many not meeting international standards. the Johnson & Johnson vaccine, as part of the
United States’ Operation Warp Speed. “By us
But South Africa oers clues. An estimated 60,000 participating, if it does go well, we’ll be helping a
more people have died there than would lot of people,” he said. There was no guarantee,
normally be expected; fewer than half have been though, that those who’d be helped would be in
attributed to COVID-19. Disrupted health services South Africa.
may account for some of them, but researchers
believe that many fatal COVID cases have gone A Rattled Health System Last month, South African
undetected. oicials thought they had a brief opportunity to
douse hot spots of infection in the Eastern Cape
Older adults, people with chronic health before they spread across the country.
conditions and those admitted to public, rather
than private, institutions are more likely to die, Crowded post oices, college dormitory parties
according to the country’s National Institute for and migrant farmer encampments were potential
Communicable Diseases. White South Africans sources of outbreaks. So were the traditional
have been hospitalized for the coronavirus at three-week initiation retreats where an expected
higher rates than their share of the population, 50,000 18-year-old boys would undergo
probably because of their higher average age. circumcision in December and January.
But the institute found that when controlling for
age, Black, Indian and mixed-race South Africans The government imposed a nighttime curfew in
were more likely than white South Africans to die Port Elizabeth and limited alcohol sales and the
of the disease in hospitals. size of gatherings. A proposal to screen nearly all
adults in the most affected areas though, was
Still, experts generally believe that fatalities on the dropped after a pilot project strained labs.
continent are far lower than in the West,
potentially for reasons beyond demographics. For Meanwhile, cases mounted, highlighting the
instance, countries that regularly immunize babies health system’s inequalities. Most South Africans
with a tuberculosis vaccine also tend to have rely on public health services; only 14% get
medical care from better-endowed private
NIRT Library News Bulletin
12providers. In Port Elizabeth one recent day, 57 of against” the protocol tacked to a wall, labeled
the 59 patients on ventilators were in private “Allocation of Scarce Critical Care Resources
hospitals. During the COVID-19 Public Health Emergency.”
Even the private sector was hard-pressed in the “If I need it, I’m going to take it away from him,
outbreak. Dr. Hlanjwa Maepa, the sole because he’s not a great candidate,” Black said.
pulmonologist at Netcare Greenacres Hospital,
spent her day attending to nearly 40 coronavirus According to the guidelines, patients more than
patients, inserting breathing tubes and catheters. “mildly frail” at baseline, including those who
“often have problems with stairs” and need
The hospital was not proning COVID pneumonia minimal help with dressing, were to be denied
patients — turning them on their bellies — even critical care. Other patients were to be divided
though evidence shows that it improves oxygen into low-, medium- and high-priority groups based
levels and reduces the need for ventilators. “We on preexisting conditions and degree of illness,
don’t have enough manpower to do it,” Maepa with age groups as a tiebreaker.
said.
In practice the procedure was cruder. If you’re 60
The 16-bed ICU was full, and she shifted patients with another health condition, “the chance of you
like puzzle pieces to make space for the sickest. A getting into an ICU is close to zero,” Black said. “I
wealthy executive begged her to save him have patients dying here in their 30s who couldn’t
because his aairs were not in order, asking to buy get into a hospital, and now ICUs are full.”
his own ventilator and be treated at home. A
middle-aged man sobbed as he visited his dying That night, the nursing sta wound through the
wife. “There’s a mountain coming, and I may not wards singing hymns and the Lord’s Prayer. A
be able to get over it with her,” Maepa told him. nurse who sang in her church choir beat an empty
“But we’re trying either way.” water bottle against a cardboard box labeled for
compliments and complaints.
The scene inside two of the city’s public hospitals
was more dire. Dozens of medical workers were Killing People Silently In Howlwadaag, a rubble
out sick, and patients stayed hours, sometimes filled settlement in Hargeisa for Somali and
days, in crowded observation rooms awaiting Ethiopian refugees displaced by conflict and
ward admission. One aging hospital, Dora Nginza, drought, the risks of transmission were evident.
lacked an ICU and was rushing to nish a Residents like among prickly cactuses, sleeping in
renovation because it could not properly isolate crowded corruaated sheet metal shacks and
patients. The physician in charge, Dr. Lokuthula rounded cloth-covered dwellings. Polio outreach
Maphalala, spent her shift pushing stretchers and workers advised residents to sleep separately if
lifting patients. The other public hospital, sick and wash their hands often. But community
Livingstone, had to refuse most patients who members said they could not aord soap.
needed transfer to the ICU “These cases and
A woman complaining of a cough and difficulty
faces come back to you,” said its director, Dr.
breathing rejected the advice of health workers
Lizette van der Merwe.
to go to the hospital one day this month. “I’m
At the nearby eld hospital in Port Elizabeth, afraid of people not being able to come see me,”
doctors were forced to ration. Black, the said Khadra Mahdi Abdi, adding that the price of
infectious-disease specialist, saw that a 84-year- transport was too steep.
old man had been placed on a high-ow oxygen
device, a decision he said was “completely
NIRT Library News Bulletin
13In the region, the pandemic often inspires denial. A caretaker at the cemetery’s entrance
Restaurants are busy, social distancing rare, large produced a notebook with handwritten entries for
family gatherings common. Mask wearing carries the deceased. Because families often dug graves
a stigma. for their loved ones, he said, he logged only some
of the burials and did not share his list with the
“People are watching you and point their ngers at government.
you and say, ‘This is corona man,” said Hassan
Warsame Nor, a senior lecturer at Benadir
University, in Mogadishu, who led a UNICEF study
of attitudes in Somalia’s capital.
And resisting medical treatment is routine.
At Hargeisa’s designated COVID hospital, Daryeel,
ve patients separated by empty metal frame Dry run for Covid-19 vaccination
beds lay beside hissing oxygen tanks, with
handwritten medication orders taped to the walls.
on January 2: All you need to
Nurses swatted away lies that few in through know
windows facing a courtyard, where patients were
sometimes rolled for a dose of sunshine and bird TIMESOFINDIA.COM | Dec 31, 2020, 05.12 PM IST
song. Most had a family member attending them,
NEW DELHI: India is likely to have the much-
which the hospital director, Dr. Yusuf M. Ahmed,
awaited Covid-19 vaccine in the New Year and
felt compelled to allow.
the Centre is gearing up for the massive
He said that about 80% of patients scheduled for vaccination drive.
transfer to Daryeel after testing positive at the
As part of the preparations, the Centre has asked
main public hospital never showed up. People
all states and Union territory administrations to
were dying at home. “The virus is now killing
carry out a dry run for the vaccination drive on
people silently,” said Dr. Hussein Abdillahi Ali, a
January 2.
junior physician there.
This will be the second dry run and will test the
Judging by the condolence pages on Facebook,
linkages between planning and implementation
the director said, COVID-19 has come back “with
to identify the challenges in the process.
a vengeance.”
Here are the details of the planned dry run drive:
At least two of those hospitalized that day later
died. “Patients are coming at a late stage,” he
* Activity to be conducted in all state capitals in
said. “It’s much harder than the rst round.”
at least 3 session sites.
At the Baqiic cemetery on the outskirts of Hargeisa,
* Some states will also include districts that are
about 50 men and boys gathered at a grave site
situated in difficult terrain/have poor logistical
this month to bury a family matriarch who had
support.
died of unknown causes. Their shovels hit the
ground in a frenzy, causing a plume of earth to rise * For each of the three session sites, the Medical
in the air like smoke. Officer In-charge will identify 25 test beneficiaries
(healthcare workers).
NIRT Library News Bulletin
14* Maharashtra and Kerala are likely to schedule * A total of 2,360 participants have been trained
the dry run in major cities other than their capital in National Training of Trainers and over 57,000
participants trained in districtlevel training in 719
* The planning for the vaccine introduction will be districts.
as per the Operational Guidelines issued by the
health ministry on December 20. * States are augmenting the state helpline 104
(which shall be used in addition to 1075) for any
* States and UTs have been asked to ensure that vaccine/software-related query.
the data of these beneficiaries is uploaded in Co-
WIN. * An important focus of the dry run will be on
management of any possible adverse events
* States and UTs shall prepare the facilities and following immunisation (AEFI).
users to be created on Co-WIN application
including uploading the data of Health Care * Focus will also be on adherence and
Worker (HCW) beneficiaries. management of infection control practices at the
session site to prevent disease transmission.
* States and UTs have been asked to ensure
physical verification of all proposed sites for * The mock drill will include concurrent monitoring
adequacy of space, logistical arrangements, and review at the block and district levels, and
internet connectivity, electricity, safety, etc. and preparation of feedback.
prepare at least three model session sites in each
state (at state capital) for demonstration. * The State Task Force shall review the feedback
and share with the Union health ministry.
* States have to ensure that the model sites have
separate entry and exit in a 'three-room set-up' * States/UTs have also been asked to address the
with adequate space outside for awareness communication challenges by taking in
generation activities. confidence all the stakeholders and by
augmenting the community engagement
* States have also to ensure that all SOPs and through innovative strategies.
protocols are being practised at the identified
sites in an ideal environment along with * Detailed checklist has been prepared by the
vaccination teams to be identified and trained in Union health ministry and shared with the states
all aspects. and UTs to guide them in the dry run.
* The dry run will also equip the state and UT "The objective of the dry run for Covid-19 vaccine
administration in management of vaccine supply, introduction is to assess operational feasibility in
storage and logistics including cold chain the use of Co-WIN application in field environment,
management. to test the linkages between planning and
implementation and to identify the challenges
* As the vaccine administrators will play an and guide way forward prior to actual
important role in the vaccination process, training implementation. This is also expected to give
of trainers and those who shall administer the confidence to programme managers at various
vaccine has been taken up across various states. levels," the Union health ministry said.
* Around 96,000 vaccinators have been trained Union health secretary Rajesh Bhushan chaired a
for this purpose. high-level meeting to review the preparedness at
session sites for Covid-19 vaccination with
NIRT Library News Bulletin
15principal secretaries (Health) and other health the PM has stressed upon the need to include
administrators of all states and UTs through video- these people in the list on priority, an official said.
conferencing.
The list of 'priority' population also includes people
The first round of the dry run was conducted in above 50 years of age and those below 50 years
Andhra Pradesh, Assam, Gujarat, Punjab on 28-29 but with serious comorbidities. The PM on Thursday
December in two districts each where five session also cautioned people against any rumours about
sites with 25 beneficiaries each were identified. vaccination.
No major issues were observed in the operational "Different people for their vested interests or due
aspects during this dry run. All States expressed to irresponsible behaviour spread various rumours.
confidence in the operational guidelines and IT May be rumours will be spread when vaccination
platform for large scale programme begins, some have already begun," he said,
implementation, the ministry said. asking people to be careful about such rumours
and as responsible citizens refrain from forwarding
such messages on social media without checking.
Covid: Sanitation staff, pharmacists
may be on 1st vax list
TNN | Jan 2, 2021, 03.58 AM IST Registration, eligibility, schedule:
NEW DELHI: Amid speculation whether sanitation
All your Covid vaccine questions
workers and pharmacists will be considered for answered
vaccination against Covid-19 in the initial phase,
the government has started working to include TIMESOFINDIA.COM | Jan 4, 2021, 10.24 AM IST
them in the 'priority' population after PM Modi
lauded theirs efforts as 'frontline' corona warriors NEW DELHI: Will the vaccine be given to everyone
during his speech on Thursday while laying the simultaneously? When will antibodies develop?
foundation for AIIMS, Rajkot. How will a vaccine be chosen for administration?
The government aims to inoculate 30 crore With India ready to roll out the Covid-19 vaccine,
people in the first phase of Covid-vaccination the government on Sunday tweeted a three-part
which includes around 3 crore healthcare and video series to answer several frequently asked
frontline workers. Apart from doctors, nurses, ANMs questions about the vaccination process.
and ASHAs, the plan was to include some of the
In a video released by the Union health ministry, All
allied health professionals such as those working in
India Institute of Medical Sciences (AIIMS) director
diagnostic labs and pharmacists. Besides,
Dr Randeep Guleria gave a brief explanation on
sanitation workers, scavengers and ambulance
the entire process and addressed general
operators are also being considered to get the
concerns surrounding the Covid-19 vaccine.
vaccine in the first phase.
Here are all the vaccine-related queries
While some of the categories lacked clarity, the
answered by the AIIMS chief:
mention of sanitation workers and pharmacists by
NIRT Library News Bulletin
16 Is a Covid-19 vaccine scheduled anytime site of side-effects, body aches, etc. States
soon? …… have been asked to make arrangements to
Yes, vaccine trials are in different stages of deal with any side-effects as one of the
finalisation. Many vaccines are undergoing measures towards ensuring safe vaccine
Phase 3 trials which are almost complete. delivery.
Once the regulatory clearance is given, the Out of the multiple vaccines available, how is
government is all geared up to launch the one or more chosen for administration?
vaccines. The safety and efficacy data from the clinical
trials are examined thoroughly by the drug
Will the vaccine be given to everyone regulator before granting license for the same.
simultaneously? Hence, all the vaccines that receive the
This will depend on the availability of vaccines. license will have comparable safety and
The government has also selected priority efficacy. However, it's important that we
groups based on risk factors. The first group will ensure that the entire vaccination schedule is
include healthcare and frontline workers, the completed with one type of vaccine as
second group will be people over the age of different vaccines are not interchangeable.
50 and those under 50 with comorbid How will I know if I am eligible for vaccination?
conditions. In the initial phase, the Covid-19 vaccine will
Is it mandatory to take the vaccine? be provided to the priority groups. The eligible
Taking the vaccine is voluntary. However, it is beneficiaries will be informed through their
advisable to take the complete vaccine registered mobile number regarding the
schedule as far as Covid-19 is concerned health facility where the vaccine will be
because we want to protect ourselves as well provided and the scheduled time for the same.
as near & dear ones. This will be done to avoid any inconvenience
How many doses of the vaccine would have in registration and vaccination of beneficiaries.
to be taken by me, and at what intervals? Can I get the vaccine without registration?
Two doses of vaccine, 28 days apart are No. I don't think that would be right. The
needed and this needs to be taken by all to registration is mandatory and the information
complete the vaccine schedule. on the session site will be shared only after
Who will get vaccinated first? registration. (The government has announced
Healthcare/frontline workers, people over 50 Co-Win app, a digital platform for real-time
and those under 50 with comorbidities monitoring of vaccine. It will also enable
Is vaccine must? No, but it's highly people to get themselves registered for
recommended vaccination.)
How many doses will I get? What documents are required for the
Two doses of vaccine, 28 days apart are registration of an eligible beneficiary? The
needed and this needs to be taken by all to following documents can be produced with a
complete the vaccine schedule. photo at the time of registration: Driving
When will antibodies develop? license, Health Insurance Smart Card issued
Protective level of antibodies generally will under the scheme of labour ministry,
develop two weeks after receiving the second MGNREGA job card, official ID cards issued by
dose of Covid-19 vaccine. MPs/MLAs/MLCs, PAN card, passbooks issued
What about the possible side-effects? by banks/post office, passport, pension
As is true for all other vaccines, we will have documents, service ID cards issued to
some degree of common side-effects. These employees by central/state govt/Public Ltd
could be in the form of mild fever, pain at the Companies or Voter ID cards.
NIRT Library News Bulletin
17 What if I don't have a Photo ID? Will the vaccine be safe as it is being tested
Photo ID is a must for both registration and and introduced in a short span of time?
verification of beneficiary at session site to Vaccines will be introduced in India only after
ensure that the intended person is vaccinated. regulatory bodies clear it for safety & efficacy.
How will the beneficiary received information All standard precautions taken in the past for
about the due date of vaccination? vaccine approval will be taken this time as well.
Following online registration, beneficiaries will Will the vaccine introduced in India be as
receive SMS on their registered numbers on the effective as the ones introduced in other
due date, place and time of vaccination. countries?
Will I get info on status of vaccination after Yes. The vaccine introduced in India will be as
completion? effective as any vaccine developed by other
Yes, on getting the due dose the beneficiary countries. Various phases of trials are
will receive SMS on their registered number. undertaken to ensure the safety and efficacy.
After all doses are administered, a QR-code
based certificate will also be sent.
Can a person presently having active and
symptomatic infection be vaccinated?
People with active and symptomatic infection
may increase the risk of spreading the same at
vaccination sites. Also, we don't know how
effective the vaccine will be in such a situation.
For this reason, I believe that people with Covid-19 vaccine dry run at 6
infection should defer the vaccination for at centres in Agra on January 5
least 14 days after the symptoms are resolved. TNN | Jan 4, 2021, 04.42 AM IST
Is it necessary for a Covid recovered person to
receive vaccine? AGRA: The dry run of Covid-19 vaccine will be
Yes, it is advisable to receive the complete conducted in Agra on January 5. Full rehearsal will
schedule of vaccine irrespective of past history be carried out at six centres in Agra district. The
of infection with Covid-19. This will help you to health department has called 150 individuals to
develop a better immune response against participate in the dry run. Besides deep freezers for
the disease. storage, arrangement of around 3.60 lakh syringes
If one is taking medicines for illnesses like has been made to administer the vaccine. Chief
cancer, diabetes, hypertensions, etc, can he medical officer Dr RC Pandey said, “All required
or she take the vaccine? arrangements have been made for the dry run of
Yes, I think it's very important that such Covid-19 vaccine on Tuesday. In this regard,
individuals take the vaccine because they're doctors and heath staffers have been assigned
high-risk groups. It's important for them to duties at six centres. Except administering the
understand that the medicines will not affect actual vaccine, the entire process of vaccination
the vaccine efficacy. will be rehearsed. The exercise is aimed to avoid
Any preventive measures/precautions that loopholes in the actual vaccination process.”
one needs to follow at the session site?
Yes, I would request that you take at least half- The dry run of Covid-19 vaccine will take place at
an-hour rest after getting vaccinated. In case SN Medical College, Pushpanjali hospital and
of any discomfort or symptoms, please inform community health centre at Naraich, Achnera,
the nearest authorities so that they can attend Khandoli and Baroli Ahir.
to you.
NIRT Library News Bulletin
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