Covid-19: Catalyst for a comprehensive law to combat potential pandemics in India

Despite the relative decline in communicable diseases, India witnesses hundreds of outbreaks every year. Including the current Covid-19 pandemic, India has suffered through several major pandemics and large-scale epidemics since 1900s. However, the response to most of the epidemics has been inadequate. The Epidemic Diseases Act, enacted in 1897 (EDA 1897), has been in action since and is based on the science and the socio-political environment of the country in the nineteenth century. India has several legal mechanisms to help contain and control the spread of epidemics, but on different platforms. There has been a paradigm shift in the socio-political milieu as well as scientific advancements in the prevention and control of epidemics. The century-old EDA 1897 has not been effective in containing and controlling such epidemics/pandemics, as has been witnessed during the ongoing Covid-19 pandemic. Hence, it needs to be revised to define an appropriate structural scalar chain, provide clear-cut and unambiguous terms/definitions and guidelines, delineate ethics and human rights, determine the duties and responsibilities of the affected population/community, determine the role of the private health sector, and provide for appropriate punitive measures to deter repeated violations.

Role of BCG and Measles vaccination in protection against COVID-19 infection and severity of the disease: A pilot case-control study

Background: The role of BCG and MMR/Measles vaccination in reducing the burden of COVID-19 has been based on ecological data mostly. We planned this explorative pilot case-control study to understand the role of vaccination with Bacillus Calmette朑uerin (BCG) and measles administered as part of MMR vaccine on COVID 19. Methodology: A case-control study was conducted in AIIMS Patna during December 2020 and January 2021. A total of 100 COVID-19 patients confirmed by RT-PCR test were taken as cases, and for each case, age and gender-matched SARS-COV-2 negative individual was taken as control. A study tool containing a pre-tested semi-structured questionnaire was used. Results: The unadjusted odds of COVID-19 were found to be significantly higher among BCG vaccinated [1.88(1.03-4.4)] and MMR vaccinated individuals [5.06(2.34-10.90]. BCG vaccine was not found to have an independent effect on COVID-19 after adjusting for tobacco use, MMR vaccination status, unprotected contact with SARS-COV-2 positive patients, and co-morbidities. But Measles vaccine was found to independently increase the risk of COVID-19 [AOR: 4.505(1.8-11.3)]. Conclusion: BCG vaccination status was not found to be an independent predictor of COVID-19. Further studies with large sample size and better study design (cohort, randomized trials) need to be conducted.