|Year : 2019 | Volume
| Issue : 1 | Page : 1-2
Quo vadis COVID responder – Beat the chinese virus, carpe diem
Brij B Agarwal1, Nayan Agarwal2
1 Department of General and Laparoscopic Surgery, Ganga Ram Institute of Post Graduate Medical Education and Research, New Delhi, India
2 Department of Radiation Oncology, Maulana Azad Medical College and Associated Hospitals, Delhi University, New Delhi, India
|Date of Submission||27-Apr-2020|
|Date of Acceptance||12-May-2020|
|Date of Web Publication||30-May-2020|
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Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Agarwal BB, Agarwal N. Quo vadis COVID responder – Beat the chinese virus, carpe diem. Indian J Colo-Rectal Surg 2019;2:1-2
Coronavirus disease 2019 (COVID-19) has obliterated the geographical, cultural, racial, occupational, and economical barriers to our privileged sense of well-being. The virus poses an existential risk, reminding us of our universal connectedness. It has exhorted us to introspect for the means of civilizational prosperity and the technological prowess at our command with the helplessness at our heels. The alchemy for future has suddenly reminded us that the past is neither dead nor past, as told to the protagonist in “Requiem for a Nun” by William Faulkner. Times have somersaulted, our future seems to be lying the past again. Existential risks such as “Extreme Technology,” “Catastrophic Biology-Biodiversity Loss,” “Extreme Environments,” and “Advanced Artificial Intelligence” have long been identified (https://www.cser.ac.uk/), yet the biology of COVID-19 arrived as an existential threat. The threat calls for commandeering everything at hand, from wisdom of the past to present, from traditional to modern, and from common-sense to evidence. Till a definite cure or vaccine becomes available, we need our imagination to forge Innovations with Molecular biology, Ancient wisdom, Genomics, Infotech, and Nanoscience, to engineer (IMAGINEERING) a balm for COVID-19-impacted humanity. The insights from the existential literature, imaginative or experiential, from Prometheus, Lucifer, Frankenstein (Marry Shelly – 1818), Spanish Flu of 1918, and Contagion (Steven Soderbergh – 2011), call for Imagineering to study the traditional wisdom through a scientific mirror of beneficence till the evidence emerges to fight COVID-19.
While we cannot kill the Chinese Virus as yet, we can dismantle the epidemiological triangle by its other two arms, i.e., environment and host. The environmentalists, policymakers, administrators, and social scientists are already doing their best by implementing social distancing, individual quarantines to wider lockdowns, scaling up medical resources, triage for optimized health-care infrastructure, and stabilizing existential economies. We need to work upon the host. The genome of the catastrophic biology of COVID-19 and its molecular insult pathway leading to a cytokine-driven inflammatory storm that potentially overwhelms the physiological existence is known. The healthy state inflammatory response (IR) causes immunosuppression, but proceeds to anti-IR. Unchecked IR can prolong immunosuppression and lead to potentially fatal systemic IR syndrome (SIRS). Pathogen- or danger/damage-associated molecular patterns (PAMPs or DAMPs) mediate the cytokine-driven IR. The DAMPs further accentuate the PAMPs. The danger-DAMP triggered cytokine storm can be attenuated by nonharmful interventions such as mind–body interventions, breathing exercises, and music, even in high-risk morbidities., The DAMP-associated sterile IR has also been shown to be attenuated by constituents, especially curcumin in Indian diets. Commensal organisms comprising almost 90% of cells on/in the human body are essential for healthy progression of IR to pro-immunity and anti-inflammatory status, reducing the potential SIRS. The benefits of gut commensal microbes have been utilized in fecal microbiota transplant as they provide a protective surface shield and boost gastrointestinal immunity, but also have a positive impact. Healthy commensal flora on a healthy human body is a factor of environmental exposure from in utero to community cohabitation with a healthy biodiversity including the native cattle population. The cohabitating biodiversity has included cattle, etc., in a majority of Indian households. There is robust evidence for the benefits of commensal organisms cohabitating with human physiology. The source of these beneficial commensal is the environment around us and the ecosystem we live including the other life forms associated with our daily existence and close interaction. The regular and universal use of curcumin in Indian meals, universal mind–body practice of yoga including trained deep breathing with religious adherence, and biodiversity-inclusive human–cattle cohabitation might play some role in attenuating DAMP-driven IR and may also be leading to a truly diverse commensal microbiota, benefiting the pro-inflammatory-immunity-anti-inflammatory interplay. It might be one of the factors in a so far reassuring incidence of COVID-19 in India. The molecular benefits of these regional factors and practices seem to be marginal, but impactful benefits have been achieved by “the aggregation of marginal gains.” Our experiences are evolving; ancient practices have not been put to the scientific rigors of hypothetico-deductive-reasoning methodology mandatory for evidence to emerge. Extraordinary circumstances, such as the existential COVID-19 crisis, demand extraordinary measures. Nonharmful interventions need attention of the community, looking for marginal progress on many fronts of this battle. Harmless innovative ideas, in helpless clinical scenarios, should not wait for evidence to emerge.
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