Vitamin D, good hygiene — chief of India’s top nutrition body shares key Covid tips
Secunderabad: There are no specific guidelines about an appropriate diet for Covid-19 patients but Vitamin D supplements could result in lower chances of morbidity, says Dr R. Hemalatha, the director of the Hyderabad-based ICMR-National Institute of Nutrition (NIN).
In an interview with ThePrint, Dr Hemalatha, an expert in microbiology and immunology, discussed a range of subjects pertaining to the Covid-19 pandemic: From allegations of low testing rates in Telangana, to the WHO’s decision to pause HCQ trials, which has since been reversed, and advisories on ayurveda.
Dr Hemalatha cited “certain preliminary data collected from nearly 10 countries with respect to coronavirus”, to claim that individuals with low serum levels of Vitamin D showed a higher mortality rate.
“You should have enough stored vitamins in your body and sufficient vitamins and minerals that you are taking when you are sick as they go a long way in fighting the progression of the disease and also reducing mortality,” she said.
She pointed to the high deficiencies of iron, calcium, zinc, Vitamin A and D among citizens of the country, and said 50 per cent of India’s population suffered from anaemia.
Micronutrients, she said, can play a pivotal role not only in enhancing immunity but also regulating it. “This is so that unchecked proliferation doesn’t occur or to keep inflammation in check… they also scavenge all the dead cells in the process.”
‘Can’t recommend ayurveda’
The NIN is a 102-year-old institute that went by different names before its current one was finalised on its golden jubilee.
Located on the campus of the Osmania University, the NIN is tasked with studying nutrition and finding solutions to the problems surrounding it.
Dr Hemalatha took over as the 13th director of the NIN in December 2017.
Speaking to ThePrint, the NIN director said she was sceptical about the potential of ayurveda to treat Covid-19. “In modern science, we don’t believe in anything unless there is hard data that can be validated after it has been tested in a huge population. We cannot recommend it,” she said.
In collaboration with the Telangana government, the ICMR-NIN finished conducting a rapid survey in five containment zones across Hyderabad Sunday as part of an ICMR exercise to understand Covid-19 exposure in the country.
Under the first phase, the ICMR covered 69 districts from 21 states and 13 hotspots across the country. This includes Hyderabad and two other districts in Telangana, and the results are awaited. Hyderabad is among 13 hotspots covered by a central team, of which Hemalatha is a part.
“In each district of Telangana, 10 villages were covered besides five containment zones in Hyderabad for which results will be out in another 10 days,” she said, adding that high-risk contacts including healthcare workers, police personnel and journalists are being included in the second part of the survey that started Tuesday.
‘Telangana following ICMR guidelines’
Telangana has been under fire from the central government for its low testing rates. While Hemalatha agreed that the state’s 30,000 tests were relatively fewer as compared to its neighbours, she said Telangana has been “following ICMR guidelines and has improved the numbers relatively now”.
She added that community transmission cannot be gauged by hearsay. “There is transmission in certain containment zones and selective pockets, be it in Telangana or other parts of the country,” she said, adding that the result of the survey will also help confirm the extent of transmission, especially in rural areas.
According to data released by ICMR, India conducted over 10 lakh Covid tests between 22 January and 30 April, of which over 40,000 tested positive. While questions have been raised about India’s testing rate in comparison with that of other countries, Hemalatha defended the nation’s testing drive. The incidence of Covid-19 in India, she said, doesn’t warrant random testing.
“This is what I don’t understand, where the number of tests or positive cases is ranging from 5 per cent to more than 20-30 per cent in the rest of the world, in India, the number has been lower… So, if we conduct 100 tests, there were days where 20-30 positives were reported in other countries, while in India it was limited to 5-10 being positive.”
She agreed that testing was low initially but said India has now ramped it up in keeping with the requirements.
Weighing in on calls for random testing, she added, “We are not doing random testing. We cannot go randomly and collect throat swabs in patients who are not symptomatic… Do you think they will agree when they have no symptoms or there is no contact history?”
Discussing the seemingly low Covid-19 mortality rate in India, she referred to a group of genes called MHC or major histocompatibility complex, and its importance in generating a stronger immune response.
In India, she said, people have a much higher variety of MHC and, therefore, the immune response “after a virus enters our bodies is perhaps more well regulated due to such genetic differences”.
Good hygiene a good idea
The novel coronavirus is just the latest member of a family of viruses known to cause a range of diseases from the common cold to the Severe Acute Respiratory Syndrome (SARS), which spread widely in Hong Kong in the early 2000s.
Hemalatha said the novel coronavirus, the virus that causes Covid-19, results in “lower-level” respiratory issues than its peers but is more contagious.
“The transmission from one individual to another is much more rapid and wider in this coronavirus as compared to others although it causes lower-level respiratory issues,” said Dr Hemalatha, adding that it has been dubbed “novel” precisely for its “peculiarity”.
She said there is no evidence to conclude the prevalence of different strains of coronavirus in different parts of the country. Asked why Maharashtra and Gujarat have higher Covid-19 incidence than, say, Tamil Nadu, she stated that the disease is more prevalent in states where more people have returned from abroad and where the population density is higher.
Hemalatha also expressed scepticism about the controversial May study published in The Lancet, conducted by researchers from the US and Switzerland, which linked hydroxychloroquine (HCQ) to higher mortality among Covid-19 patients.
Hydroxychloroquine, an anti-malarial drug, is being explored as a possible treatment for Covid-19, which doesn’t have a vaccination or exact cure yet, but The Lancet study led the WHO to suspend its HCQ trial. However, the trial, part of the WHO’s giant Solidarity initiative, was resumed Wednesday after the study came under the lens.
Talking about the study, she said she didn’t get the kind of toxicity being reported.
“In India, we have a very ancient history of using this particular drug… so it is a safe drug except for certain situations and there are guidelines by ICMR that clarify the conditions under which it should not be used and the precautions that need to be taken,” said Dr Hemalatha, who spoke to ThePrint before the trial was resumed.
Talking about Covid-19 prevention, she said there was ambiguity in the studies regarding its transmission, but noted that good hygiene is always a good idea.
She said objects, be it paper or spoon, can transmit the coronavirus, especially if “an infected individual coughs without a mask and touches somewhere and someone else comes in contact with that or touches it”.
“Not just coronavirus, but even TB and several diarrhoea-causing diseases can be prevented through proper hygiene habits of sanitising, washing hands regularly, wearing a mask,” she added.
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