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Table of Contents
Year : 2019  |  Volume : 2  |  Issue : 1  |  Page : 1-2

Quo vadis COVID responder – Beat the chinese virus, carpe diem

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 Submission27-Apr-2020
Date of Acceptance12-May-2020
Date of Web Publication30-May-2020

Correspondence Address:
Nayan Agarwal
F-81 and F-82, Street No. 4, Virender Nagar, Janakpuri, New Delhi - 110 058
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2666-0784.285433

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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

How to cite this URL:
Agarwal BB, Agarwal N. Quo vadis COVID responder – Beat the chinese virus, carpe diem. Indian J Colo-Rectal Surg [serial online] 2019 [cited 2022 Dec 2];2:1-2. Available from: https://www.ijcrsonweb.org/text.asp?2019/2/1/1/285433

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.[1] 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.[2] 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.[3] The DAMPs further accentuate the PAMPs.[4] 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.[5],[6] The DAMP-associated sterile IR has also been shown to be attenuated by constituents, especially curcumin in Indian diets.[7] 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.[8] 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.[9] 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.[10]

  References Top

Isbell F, Gonzalez A, Loreau M, Cowles J, Díaz S, Hector A, et al. Linking the influence and dependence of people on biodiversity across scales. Nature 2017;546:65-72.  Back to cited text no. 1
Agarwal BB. Journey of the carbon-literate and climate-conscious endosurgeon having a head, heart, hands, and holistic sense of responsibility. Surg Endosc 2008;22:2539-40.  Back to cited text no. 2
Alazawi W, Pirmadjid N, Lahiri R, Bhattacharya S. Inflammatory and immune responses to surgery and their clinical impact. Ann Surg 2016;264:73-80.  Back to cited text no. 3
Gallucci S, Matzinger P. Danger signals: SOS to the immune system. Curr Opin Immunol 2001;13:114-9.  Back to cited text no. 4
Yamasaki A, Booker A, Kapur V, Tilt A, Niess H, Lillemoe KD, et al. The impact of music on metabolism. Nutrition 2012;28:1075-80.  Back to cited text no. 5
Okada K, Kurita A, Takase B, Otsuka T, Kodani E, Kusama Y, et al. Effects of music therapy on autonomic nervous system activity, incidence of heart failure events, and plasma cytokine and catecholamine levels in elderly patients with cerebrovascular disease and dementia. Int Heart J 2009;50:95-110.  Back to cited text no. 6
Agarwal KA, Tripathi CD, Agarwal BB, Saluja S. Efficacy of turmeric (curcumin) in pain and postoperative fatigue after laparoscopic cholecystectomy: A double-blind, randomized placebo-controlled study. Surg Endosc 2011;25:3805-10.  Back to cited text no. 7
Maslanik T, Tannura K, Mahaffey L, Loughridge AB, Beninson L, Ursell L, et al. Commensal bacteria and MAMPs are necessary for stress-induced increases in IL-1β and IL-18 but not IL-6, IL-10 or MCP-1. PLoS One 2012;7:e50636.  Back to cited text no. 8
Webb BJ, Brunner A, Ford CD, Gazdik MA, Petersen FB, Hoda D. Fecal microbiota transplantation for recurrent clostridium difficile infection in hematopoietic stem cell transplant recipients. Transpl Infect Dis 2016;18:628-33.  Back to cited text no. 9
Landreneau JP, Weaver M, Delaney CP, Aminian AL, Dimick JB, Lillemoe KD, et al. The 100 most cited papers in the history of the American Surgical Association. Ann Surg 2020;271:663-70.  Back to cited text no. 10


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