When India's 1.3 billion people come out of a 40-day lockdown on 3 May, imposed to contain the spread of COVID-19, they can hope that a battery of technologies that the government is readying to deploy against the contagious virus could offer them some protection.
So far, COVID-19 is known to have infected 29,500 people in India, of whom 939 died, as of Tuesday (28 April). Of the 525,000 people tested, so far only four per cent have been found positive — a comparatively low rate attributed to what is easily the world's harshest lockdown.
However, it's a race against time as the country cannot be kept on lockdown mode for protracted periods without suffering grievous economic losses. No one understands the urgency better than Harsh Vardhan, union minister for health, as well as science and technology, who is charged with finding technology solutions to limit a projected spike on COVID-19 cases after the lockout is lifted.
Modeling by Jawaharlal Nehru Centre for Advanced Scientific Research, Bangalore, projects that after the lockdown is lifted on 3 May infections could peak within two weeks, leading to as many as 38,000 deaths and requiring intensive medical care for 76,000 patients.
"These are times of war," Vardhan, a physician before he entered politics, told the chiefs of 38 premier research laboratories that fall under India's Council of Scientific and Industrial Research (CSIR) via a video conference on 12 April. "CSIR scientists should work to deliver solutions before the war ends."
Vardhan's personal oversight of the CSIR labs, the department of science and technology (DST) and a maze of other health and scientific establishments scattered across the country have produced a bewildering range of testing kits, sanitizers and respiratory assistive devices awaiting approval before final rollout.
A surge of innovations
First off the block is a unique paper strip test that uses CRISPR-Cas9 gene-editing technology that can detect COVID-19 within 10 minutes. Developed by CSIR's Institute of Genomics and Integrative Biology (IGIB), New Delhi, the kit costs only US$7 per test compared to US$65 per test using currently available imported kits.
Debojyoti Chakraborty, a leading member of the IGIB scientific team, tells SciDev.Net that the specificity of the test is 100 per cent, meaning that all positive samples show positive, while selectivity is 90 per cent, meaning that for every ten negative samples, the test will indicate only one as falsely positive.
Then there's GeneLAMP-N, a diagnostic kit that detects the highly specific N gene of the COVID-19 virus developed by DST's Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, in Kerala state.
"We are waiting for a final nod from ICMR (Indian Council of Medical Research) before licensing out the technology for mass manufacture," Swapna Vamadevan, spokesperson for Institute tells SciDev.Net.
Only test kits with proven, near-100 percent reliability for specificity and sensitivity, are recommended for commercial use by the ICMR — India's apex body for the formulation, coordination and promotion of biomedical research.
Other emerging innovations are focused on ventilators and equipment needed for treating severe cases of COVID-19.
The Sree Chitra Tirunal Institute for Medical Sciences and Technology has also developed an artificial manual breathing unit which can assist critically-ill patients to breathe in settings where no regular ventilator is available. The technology, now undergoing clinical trials, is set to be mass manufactured by Wipro3D, Bangalore.
Another portable ventilator, developed by the Tinkering Lab of the Indian Institute of Technology at Roorkee, uses an automated process to control pressure and flow rates during inhalation and exhalation by the patient.
A truly affordable respiratory support device is one by Dynamatic Technologies, a Bangalore-based precision-engineering group. Amitabh Kant, the chief of Niti Aayog, India's development agency, described the equipment in a tweet as "zero electricity, No imports, No electronic components, maintains max/minimum pressure, controlled oxygen mix, controlled breathing rate, cost US$33".
Questions on viability and availability
But there are questions whether these hundreds of technologies being developed in the laboratories will be commercially viable at all and whether it will be made available on time due to bureaucratic delays.
There are hundreds of cool technologies being developed but most of them may never see the light of day."
Amitabh Bandhyopadhyay, Professor ,Indian Institute of Technology, Kanpur (IIT-K)
Bandhyopadhyay, a former postdoctoral research associate at Harvard Medical School, has been trying to get manufacturing licenses for three IIT-K innovations targeting COVID-19, including an advanced N-95 mask using four-layer melt-blown technology for viral and bacterial protection and a disposable laminated suit for security guards, sanitization workers, health professionals and paramedics who need to have personal contact with people suspected to be victims or carriers of COVID-19.
According to Acuite Ratings — a leading rating and research firm accredited to the Reserve Bank of India — the Indian economy loses US$4.5 billion for each day of lockdown. That would mean total losses worth US$160 billion by the time the lockdown is lifted.
Leading physicians like Jacob Puliyel, head of pediatrics at New Delhi's St. Stephens Hospital, say that such economic losses are unacceptably high. "As theory, flatten-the-curve sounds plausible. In practice all it does is flatten the economy and inflict huge suffering and deaths. In the end the virus was not much worse than flu and the lockdown was unnecessary," Puliyel argues.
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