November 6, 2020: COVID-19 doesn’t seem to spare anyone, and especially to those having comorbid conditions such as diabetes. In India, 73% of the COVID-19 deaths are linked with comorbidities including diabetes, hypertension, cardiovascular and respiratory diseases, reveals the data of the Ministry of Health and Family Welfare, GoI. Undoubtedly, Diabetes has been observed among the most common comorbidities in COVID-19 patients.

In the diabetes awareness month, to know the role of diabetes in aggravating diabetes onslaught, the truth behind COVID induced diabetes and other diabetes-related issues were discussed at length in ‘India COVIDiabetes E-Summit’ organised  by the ‘Healthcare Advocacy Group’ — HEAL Foundation in association with ICCIDD on 5^th Nov’ 2020.

‘India COVIDiabetes e-Summit’ was the 10^th Episode of the HEAL-Thy Samvaad series, wherein public healthcare experts, Diabetologists, Endocrinologists and heads of medical research bodies participated vigorously; deliberated on different topics of the e-Summit and supported to celebrate ‘Blue Diwali’ with a purpose to inculcate awareness around diabetes amongst the masses and its prevention as ‘Blue-colour’ depicts the sky that vaults all national borders: A way of saying diabetes affects us all. Coincidently, first time in 20 years World Diabetes Day (WDD) and the festival Diwali are falling on 14^th November 2020.

During the keynote address of ‘India COVIDiabetes E-Summit’ — the 10^th Episode of HEAL-Thy Samvaad on ‘Best learnings of Diabetes Management in COVID-19 Times and ‘COVID induced diabetes: A reality or a myth’ Dr Shashank R Joshi, Padma Shree Awardee, Chair, International Diabetes Federation, South East Asia, Dean, Indian College of Physicians, Endocrinologist, Joshi Clinic, Lilavati Hospital, Apollo Sugar Clinic & Bhatia Hospital while answering a question put by Dr Swadeep Srivastava, Founder, HEAL Foundation and co-moderator of the E-Summit on the Indian Sugar Mills Association (ISMA’s) campaign of encouraging Indians to eat more sugar endorsed by the govt., said, “I condemn this initiative as this is not something we are proud of. Every 6 second, we are losing people with diabetes on the planet. We are in ‘Diabetes Awareness Month’, it is important to recognise that sugar kills. And sugar is a form of tobacco. I think trying to promote excess consumption of sugar is detrimental to health. And, such type of initiative if it is done by the govt., probably, I think, it hasn’t had the oversight of the health department, and I am certain that health department and experts will take it into cognisance and they will make their course correction. Probably, this has been done without their knowledge. It may have done by the sugar bodies to increase sugar consumption.”

“We have two things — we have severe malnutrition in India and that might need a little bit of sugar, normal healthy people need a little bit of sugar with exercise. Unfortunately, we are sedentary Indians and we keep eating, we love sweets. But caloric access is not recommended. All Non-communicable diseases can be increased by diabetes. Remember why diabetes is a big disruption in COVID because sugar is a cultural medium to grow any virus. As far as COVID-induced diabetes is concerned, so many patients who neither had diabetes nor any family history before they were contracted with COVID-19, but after 3-4 months, they are diabetic. Yes, there is COVID-induced diabetes as a distinct entity,” added Dr Joshi.

Answering the Indian Sugar Mills Association (ISMA’s) campaign of encouraging Indians to eat more sugar endorsed by the govt., while addressing the ‘India COVIDiabetes E-Summit’ — the 10^th Episode of HEAL-Thy Samvaad, Dr Navin Verma, Assistant Director, Centre for Non-Communicable Diseases, NCDC, New Delhi, said, “Malnutrition maybe a component which needs to be addressed but not by promoting sugar in general. And definitely, if health ministry or other ministries have different opinions regarding this, they should sort it out. He further added that government has already issued guidelines in August to screen every diabetic patient. As lifestyle activities are the sheet anchor of all non-communicable diseases and diabetes is also a non-communicable disease, we need to correct our lifestyle to stay healthy.”

Elaborating on the COVID’s role in aggravating diabetes onslaught, Dr AK Jhingan, Chairman, Delhi Diabetes Research Centre, said, “Diabetics are very prone to COVID-19 infection. The normal morbidity in COVID is 2.3% while in diabetics, it is 7.3% — three times more. I have seen during the COVID scourge that elderly people, as well as 60% of males with diabetes, are the most vulnerable lots. As far as the sugar intake is concerned, the American Heart Association recommends for the male to take 36 gm and to women 24-25 gm added sugar daily.”

Addressing the ‘India COVIDiabetes E-Summit’ — the 10^th Episode of HEAL-Thy Samvaad, Ms Shilpa Joshi, RD, Director, Mumbai Diet and Health Centre, Vice President, Indian Dietetic Association, Hon’ble Secretary-All India Association of Advancing Research in Obesity, said, “One of the greatest problems in Indian diet is the high content of carbohydrate. We need to reduce it. Usually, people take 60-65% carbohydrate in their diet while it shouldn’t be more than 50%. Ensure that the fat intake should be from natural sources only. Micronutrients like Zink, Vitamin B-12 must be provided to the COVID-19 patients to prevent infection. We need to hydrate with water and not with Cola. Increase the intake of fruits and vegetables and decrease the carbohydrate contents from the diet.”

While moderating ‘India COVIDiabetes E-Summit’ — the 10^th Episode of HEAL-Thy Samvaad, Dr J Kumar, Group Medical Director, Paras Group of Hospitals, said, “Diabetes is a normal indisposition but during COVID times, people with comorbid conditions such as diabetes has turned vulnerable. Not to speak of COVID, if you are not keeping yourself healthy, any infection can attack you. So, the take-home message is — everyone needs to be careful and diabetics should be extra careful during COVID times to stay healthy and safe.”

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New Delhi, 16^th Oct 2020: The world at large pins hopes that vaccine will be the next big thing to prevent the increasing curve of COVID-19. Currently, the researchers are racing to create one, but how long it will take to come to the fore is a curious question; and by what time entire India will get access to COVID-19 vaccine? Where do we stand in COVID-19 vaccine development? All these aspects were brought to discussion during Episode-9 of the HEAL-Thy Samvaad, organised by the ‘Healthcare Advocacy Group’ — HEAL Foundation in association with ICCIDD on 15^th Oct’ 2020.

While addressing India Vaccine Accessibility e-Summit in HEAL-Thy Samvaad and throwing light on — where do we stand in COVID-19 vaccine development, Dr Suresh Jadav, Executive Director, Serum Institute of India, Pvt Ltd., Pune, said, “India may get COVID-19 vaccine by March 2021 provided the regulators signal with the processes fast as multiple manufacturers are working on it. India is heading fast towards vaccine development as two manufacturers are already in phase-3 trial and one in the phase-2 trial, while more players are joining the race. Usually, vaccine development takes 8-10 years, but this is the third time we are able to produce this one in a short time. The WHO has also taken initiative to make the process fast and easy.”

“We can produce 700-800 million vaccine dosages every year once the things are streamlined. Although 55% of the population is below 50 years of age, yet as per the availability of vaccines, healthcare workers should get the vaccines first, then people over 60 years of age with comorbidities followed by the rest of the populace. As far as Serum Institute is concerned, we will be ready with 60-70 million dosages of vaccines by December 2020,but that will come in the market in 2021 after the clearance of licencing. Thereafter, we will produce more and more dosages by the permission of the govt.,” added Dr Jadav.

During HEAL-Thy Samvaad, while speaking on the COVID Vaccination & Consumers Rights, Prof. Bejon Kumar Misra,  International Consumer Policy Expert, Founder, JAGOGRAHAK.COM, Editor, The Aware Consumer, said, “Definitely, the vaccines will be a vital component in finally addressing the COVID-19 pandemic. However, it is important that the vaccine is thoroughly tested before rollout. For this, the government should involve experts from across the sectors such as experts from NGOs and private sectors. And the vaccine should be accessible to every section of society. Today, technology is the biggest enabler, which will help in this direction. In a nutshell, safety, efficacy and distribution without discrimination of COVID-19 vaccines are as important as its accessibility.”

While speaking on the accessibility conundrum of COVID vaccine in HEAL-Thy Samvaad, Dr-J-L-Meena-, said, “Of course, to have a check on the upsurge of COVID-19 infection, the vaccine is quintessential. However, the biggest challenge lies in its accessibility. The mechanism of the supply chain should also be redefined so that the distribution turns out equitably. For this, we need to prioritise the accessibility depending upon the vulnerability of the populace and take some strong action within the time limit. Effective governance is also required to carry out the judicious accessibility of the vaccine, which we have already.”

Recently, while attending an online WHO question-and-answer session, Ms Soumya Swaminathan, Chief Scientist, World Health Organization, reiterated the WHO’s stance against allowing the virus to spread unchecked to reach herd immunity, emphasizing that the concept should be discussed only within the context of a vaccine.

Adding further, she said, “Once we have a vaccine, we can aim to have population immunity — herd immunity — because you’ll need to vaccinate at least 70 per cent of people, have them protected, to really break the transmission.”

Elaborating on the status of the vaccine development during HEAL-Thy Samvaad, Mr Samir Deb, Pharmaceutical Professional, Consultant Vaccine & Public Affairs Consultant, South East Asia, said, “Vaccine development is a burning issue across the world now. Worldwide, there are 40 candidates in the race of vaccination. In India, 3 vaccines are going in the phase-3 clinical trial. However, COVID-19 crisis requires accelerated pathways for vaccine development. Proven success factors of H1N1 and Ebola has turned out as guiding principles in COVID-19 vaccine development. Union Health Minister has asserted that 400 million vaccines will be made available by next year. Hopefully, 20-25 crore population will get vaccine next year. Ensuring accessibility for 80% of the population is a huge task indeed.”

While moderating the HEAL-Thy Samvaad on Vaccine Accessibility in India, Mr Atul Sharma, Founder & Managing Director, HealthScape, said, “Historically, we never expected any unprecedented pandemic like COVID-19 but within a year, we are at the verge of vaccine development. And now, we are prioritising how to allocate the vaccines to a high-risk population. However, vaccination to only high risk population will not work, we need to ensure the accessibility to 80% of the populace.”

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