- March 30, 2020
unprecedented pandemic, its causes, repercussions and the ways to sail through this calamity. Indeed, this insightful scientific essay around the pandemic will give the readers a wide perspective full of niche information. He concludes his thought-provoking essay with his enlightened assertion: “To make a difference in someone’s life you don’t have to be brilliant, rich, beautiful or perfect – you just have to be caring and compassionate.”
“THE WHOLE WORLD IS ONE FAMILY”.
LOOKING AT PANDEMICS FROM THE HOLISTIC HEALTH PERSPECTIVE
By:- Dr Chandrakant S. Pandav
|अयं निजः परो वेति गणना लघुचेतसाम्।
उदारचरितानां तु वसुधैव कुटुम्बकम्॥
Ayaṃ nijaḥ paro veti gaṇanā laghucetasām।
Udāracaritānāṃ tu vasudhaiva kuṭumbakam॥
The above Shloka (a poetic form used in Sanskrit) is extracted from Maha Upanishad 6.71–75 whose English translation is “This is mine, that is his, says the small-minded, the wise believe that the entire world is a family.”
Vasudhaiva Kutumbakam phrase is part of this shloka which inculcates an understanding that “the whole world is one family”. It is a philosophy that tries to foster an understanding that the whole of humanity is one family. It is a social philosophy emanating from a spiritual understanding that the whole of humanity is made of one life energy. Unity in diversity is something that we as Indians have been practising for thousands of years, the underlying belief says the same.
|ॐ सर्वे भवन्तु सुखिनः सर्वे सन्तु निरामयाः ।
सर्वे भद्राणि पश्यन्तु मा कश्चिद्दुःखभाग्भवेत् ।
ॐ शान्तिः शान्तिः शान्तिः ॥
Om Sarve Bhavantu Sukhinah, Sarve Santu Nir-Aamayaah |
Sarve Bhadraanni Pashyantu, Maa Kashcid-Duhkha-Bhaag-Bhavet |
Om Shaantih Shaantih Shaantih ||
The above mantra (sacred utterance) is extracted from the ancient Sanskrit texts of spiritual teaching (Upanishad) which means
“May everyone be happy, may everyone be free from all diseases, may everyone see goodness and auspiciousness in everything, may none be unhappy or distressed, Om peace, peace, peace!”
The recent Corona Virus Pandemic is shaking the world and creating panic amongst the global citizens while spreading across 177 countries around the globe with more than 665 thousand cases and around 30,857 deaths (as on 12:41 PM 29th March 2020). Source: John Hopkins Corona Virus Resource Center
According to World Health Organization (WHO), a pandemic is defined as “An epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people”.
Disease and illnesses have destroyed humanity since ancient times. Widespread trade created new opportunities for human and animal interactions that sped up to such epidemics. Plague, malaria, tuberculosis, leprosy, influenza, smallpox, and others first appeared during these early years.
The more civilized humans became – with larger cities, more exotic trade routes, and increased contact with different populations of people, animals, and ecosystems – the more likely pandemics would occur.
Table-1 presents a timeline of historical pandemics and Figure-1 is a visual representation of major pandemics that have occurred over time.
Table 1: A Timeline of Historical Pandemics
|S. No.||Name||Period||Type / Pre-human host||Death toll|
|1||Antonine Plague||165-180||Believed to be either smallpox or measles||5M|
|2||Japanese smallpox epidemic||735-737||Variola major virus||1M|
|3||Plague of Justinian||541-542||Yersinia pestis bacteria / Rats, fleas||30-50M|
|4||Black Death||1347-1351||Yersinia pestis bacteria / Rats, fleas||200M|
|5||New World Smallpox Outbreak||1520 – onwards||Variola major virus||56M|
|6||Great Plague of London||1665||Yersinia pestis bacteria / Rats, fleas||1,00,000|
|7||Italian plague||1629-1631||Yersinia pestis bacteria / Rats, fleas||1M|
|8||Cholera Pandemics 1-6||1817-1923||V. cholerae bacteria||1M+|
|9||Third Plague||1885||Yersinia pestis bacteria / Rats, fleas||12M (China and India)|
|10||Yellow Fever||Late 1800s||Virus / Mosquitoes||100,000-150,000 (U.S.)|
|11||Russian Flu||1889-1890||Believed to be H2N2 (avian origin)||1M|
|12||Spanish Flu||1918-1919||H1N1 virus / Pigs||40-50M|
|13||Asian Flu||1957-1958||H2N2 virus||1.1M|
|14||Hong Kong Flu||1968-1970||H3N2 virus||1M|
|15||HIV/AIDS||1981-present||Virus / Chimpanzees||25-35M|
|16||Swine Flu||2009-2010||H1N1 virus / Pigs||2,00,000|
|17||SARS||2002-2003||Coronavirus / Bats, Civets||770|
|18||Ebola||2014-2016||Ebolavirus / Wild animals||11,000|
|19||MERS||2015-Present||Coronavirus / Bats, camels||850|
|20||COVID-19||2019-Present||Coronavirus – Unknown (possibly pangolins)||27,000 (Johns Hopkins University estimate as of 3:00 pm PT, Mar 27, 2020)|
Figure 1: History of Pandemics
- Coronaviruses are a large family of viruses that are known to cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).
- 2019-novel coronavirus (COVID-19) was first reported in Wuhan, China on December 31, 2019. This is a new coronavirus that has not been previously identified in humans.
- Most people infected with COVID-19 developed severe respiratory illness, including fever, cough, and shortness of breath.
- Mortality in most cases has been seen in the elderly and individuals with co-morbidities or weakened immune system.
How COVID-19 Spreads?
- Close contact can occur while caring for a patient, including:
- Being within approximately 6 feet (2 meters) of a patient with COVID-19 for a prolonged period.
- Having direct contact with infectious secretions from a patient with COVID-19.
- Infectious secretions may include sputum, serum, blood, and respiratory droplets.
- If close contact occurs while not wearing all recommended PPE, healthcare personnel may be at risk of infection.
How to prevent COVID-19 Spread?
1. Maintain Personal Hygiene
1.1 Wash your hands regularly for 20 seconds, with soap and water or alcohol-based hand rub.
1.2 Cover your nose and mouth with a disposable tissue or flexed elbow when you cough or sneeze
1.3 Avoid touching your mouth, eyes and nose if your hands are not clean (do not touch MEN – Mouth, Eyes and Nose).
2. Maintain Social distancing
2.1 Avoid close contact (1 meter or 3 feet) with people
2.2 Stay home and self-isolate from others in the household
3. Mobility restriction
4. Migration should not take place from urban to rural areas unless there is an emergency at home
5. Medicines as advised by the physician
6. Music Therapy – Where Medicine fails Music Heals
8. Mantra Jaap
9. Muskan Muskurana – Corona Corona iske liye bilkul mat rona iska ilaz sabke paas hai! Subah syam sabke saath Khub Hasna Khub Hasna!!
With the growing demand for hand sanitizers after this Coronavirus pandemic, people are slowly realizing the fact that proper sanitation and handwashing are the cornerstones of infection control. It is not a wonder to know that the Indus Valley Civilization (3300 BCE to 1300 BCE) had the World’s First Sanitation System, characterized by both public and private drains.
Also, the ancient texts from Manusmṛti (ancient Sanskrit scriptures dated between 200 BCE and 200 CE), contains detailed instructions on personal hygiene.
| “Those who do not learn history are doomed to repeat it”
– George Santayana (1863 – 1952)
Spanish Philosopher & Poet
A Nation which forgets its past has no future. The history of Community and Public Health date backs to ancient times. The well-being of an individual, family and society on a whole is something deeply rooted in the Indian culture.
|According to the World Health Organization (WHO), Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.|
Rather than focusing on specific pandemic, illness or specific parts of the body, Holistic Health is an approach to life. This ancient approach to health considers the whole person and how he or she interacts with his or her environment.
Laying emphasises on the connection of mind, body and spirit. The goal is to achieve maximum health and well-being, where everything is functioning at the highest level possible. This, in turn, encourages people to accept responsibility for their level of wellbeing and everyday choices that affect their health.
The following are the EIGHT important dimensions of Holistic Health (Figure 2)
Figure 2: The Eight Dimensions of Holistic Health
The Eight Dimensions of Holistic Health
- The first and most important dimension of the Holistic Health is the Physical dimension which focuses on recognising the need for physical activity, diet, sleep and nutrition.
- The second dimension is the emotional dimension, which is coping effectively with life and creating satisfying relationships
- Then comes the third dimension, Intellectual dimension which is all about the recognising creative abilities and finding ways to expand knowledge and other important skills.
- The fourth dimension is all about social well-being by developing a sense of connection, belonging and a well-developed support system
- This fifth is the spiritual dimension which focuses on expanding our sense of purpose and meaning in life
- Then comes the sixth dimension, Occupational dimension which is about personal satisfaction and enrichment derived from one’s work
- The seventh dimension is about the satisfaction one has with the current and future financial situations
- Finally, the eighth dimension is about the environment which is good health by occupying pleasant, stimulating environments that support the well-being.
|“Look deep into nature, and then you will understand everything better.”
– Albert Einstein (1879-1955)
There might be numerous questions running in the mind by now,
How to achieve all these dimensions?
The following steps will guide anyone to achieve all the above dimensions with ease.
- By creating a personal wellbeing plan
- Starting by categorising the physical, mental, emotional and spiritual parts
- Choosing one activity that will serve you in that area, in the most enjoyable and meaningful way to you.For example:
- Physical: A daily 45-minute walk outside
- Mental: Commit to morning meditation and talk to plants
- Emotional: Make time to catch up with a close friend
- Spiritual: Starting the Day with a Short Prayer
|“Remember the plants, trees, animal life who all have their families, their histories too. Talk to them, listen to them. They are alive poems.”
— Joy Harjo (1951-Present)
Give it time, effort, perseverance. We will soon experience how it is possible to create a balanced state of wellbeing. When we start to experience the value in caring for all parts of ourselves, we begin to feel more complete, fulfilled, healthier and happier. We emit a radiance that shines from inside out
What are the major challenges for India?
- Lack of awareness
- The burden of Communicable and Non-Communicable diseases
- Resistance to Change in Lifestyle
- Lack of basic facilities
- Lack of Awarenes
- The term “Holistic Health” is a new concept to the Indian Population
- Most people consider being healthy merely as the Absence of Disease
- Social stigma against important aspects such as Mental Illness
- The burden of Communicable and Non-Communicable diseases
- Communicable Diseases
- Healthy and Hygienic habits
- Hand washing
- Common/ Individual Baths
- Aqua Ducts for Fresh Water
- Covered Drainage System
- Non-Communicable Diseases
- Practise of “Tridosha” of Ayurveda
- Diet and Lifestyle Modification
- Resistance to Change in Lifestyle
- Long working hours
- Lack of physical activity
- Inadequate sleep
- Increasing levels of stress
- Shift towards unhealthy diet
- Increase in consumption of alcohol, cigarettes and recreational drugs
- Lack of basic facilities
- A very important aspect of Holistic Health is a sense of personal satisfaction
- Dwindling family and community support
- Majority of the Indian Population doesn’t have easy access to basic facilities such as
- Lack of Open Spaces for walking and exercises
How to address these challenges?
- Spreading awareness: Community Outreach
- Prevention is better than cure
- Lifestyle, dietary and behavioural modifications
Provision of basic facilities
- All these changes can be successful only if the health workforce is trained to work in tandem with modern medicine
- The structures of allopathic medical colleges, ayurvedic colleges, homoeopathic colleges, dental colleges, naturopathy colleges remain drastically different and call for a ‘transformational change’ to create integrated health and wellness clinics, not just an incremental change.
- The basic medical degree will need to combine all aspects of medical health, encompassing social, spiritual, mental and medical components of the healthcare system (integration at ministry level and college level).
- Such doctors would be closer to communities, holistic in nature will focus on preventive and promotive aspects of health
- By delivering integrated solutions that combine modern medicine, alternative medicine, diet, behaviour and yoga.
|Behavioural Health care personnel, physicians, nurses and staff need to be drastically changed and should be well versed with Sympathy, Empathy and Compassion.
Sympathy is being able to express what the person is feeling, Empathy is experiencing what a person is feeling and Compassion is the willingness to eliminate the suffering of another
Finally, here is a prayer from Purusha Suktam,
‘Purusha’ means God Almighty and ‘Suktam’ is in praise of the glory of God.
This prayer is chanted in houses, places of worship during rituals and ceremonies. Reciting this confers blessings on one’s life.
Also, chanted by Rishis before performing Yagna to prevent any obstacles or intermissions during the Yagna
|Oṃ tacchaṃ yorāvṛ’ṇīmahe | gātuṃ yagṅyāya’ | gātuṃ yagñyapa’taye | daivī” svastira’stu naḥ | svastirmānu’ṣhebhyaḥ | ūrdhvaṃ ji’gātu bheṣhajam |
śaṃ no’ astu dvipade” | śaṃ chatu’ṣpade |
om santhi’h santhi’h santhi’hi |
The Meaning of the above shloka is “We pray to the one who grants goodness. The Yagna should be completed auspiciously. We pray to the One, for whom the Yagna is performed.”
Let the angels do good to us. Let goodness prevail among all human beings, let all the animals be in peace. Let the trees, flora and fauna nurture well. May there be peace to the body, mind and the Soul. Let there be peace peace peace.
|“It is Health that is real wealth and not pieces of gold and silver”
– Mahatma Gandhi (1869-1948)
Indian Freedom Fighter
|“The purpose of life is not to be happy.
It is to be useful,
to be honourable,
to be compassionate,
to have it make some difference
that you have lived and lived well.”
– Ralph Waldo Emerson (1803 – 1882)
American Philosopher, and Poet
|अद्वेष्टा सर्वभूतानां मैत्र: करुण एव च |
निर्ममो निरहङ्कार: समदु:खसुख: क्षमी || 13||
सन्तुष्ट: सततं योगी यतात्मा दृढनिश्चय: |
मय्यर्पितमनोबुद्धिर्यो मद्भक्त: स मे प्रिय: || 14||adveṣhṭā sarva-bhūtānāṁ maitraḥ karuṇa eva cha
nirmamo nirahankāraḥ sama-duḥkha-sukhaḥ kṣhamīsantuṣhṭaḥ satataṁ yogī yatātmā dṛiḍha-niśhchayaḥ
mayy arpita-mano-buddhir yo mad-bhaktaḥ sa me priyaḥ
The translation of the above shloka is as follows:
Those devotees are very dear to Me who is free from malice toward all living beings, who are friendly, and compassionate. They are free from attachment to possessions and egotism, equipoised in happiness and distress, and ever-forgiving. They are ever-contented, steadily united with Me in devotion, self-controlled, firm in conviction, and dedicated to Me in mind and intellect.
With great reverence and love, I am most grateful to my Guru Sri M who has very patiently explained to me the meaning of the above Verse 13-14 from Chapter 12 of Bhagavad Gita in a simplified language. Let all of us make every effort to practice it.
|To make a difference in someone’s life you don’t have to be brilliant, rich, beautiful or perfect – you just have to be caring and compassionate.”
– Dr Chandrakant S. Pandav
MBBS, MD, MSc., FAMS, FIAPH, FIAPSM
Member National Council for India Nutritional Challenges, POSHAN ABHIYAAN
Former Professor & Head, Centre for Community Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi
World Health Organization (WHO) Public Health Champion, 2017
President, Indian Public Health Association (IPHA), 2010-2013
President, Indian Association of Preventive and Social Medicine (IAPSM), 2007 – 2008
Chairperson, The Coalition for Food and Nutrition Security (CFNS), India
Regional Coordinator, Iodine Global Network (IGN), South Asia
President, Indian Coalition for Control of Iodine Deficiency Disorders (ICCIDD), India
- March 25, 2020
Some Common Queries Answered
Q. Are there differences between symptoms caused by the FLU and COVID-19?
Ans: Cough and cold could mean an allergy. A fever with cough and cold is a symptom of the flu.
When you have fever with a cough which is complicated by breathlessness, it is a symptom of
Coronavirus infection and you must call your doctor to rule it out.
Q. How effective are thermal scanners in detecting people infected with the new
Ans: Thermal scanners are effective in detecting people who have developed a fever (i.e. have a
higher than normal body temperature) because of infection with the new coronavirus. However,
they cannot detect people who are infected but are not yet sick with fever. This is because it
takes between 2 and 10 days before people who are infected become sick and develop a fever.
Q. Can a person exposed to Coronavirus transmit it to others if he/she uses a
Ans: Highly unlikely. The Coronavirus is a droplet infection. It has to be inhaled to cause the
disease. Chlorination of swimming pools to recommended levels can certainly inactivate any
virus, including COVID-19.
Q. Should people avoid eating meat-based food to prevent transmission?
Ans: It is a respiratory virus and not a food-borne one. Coronavirus has nothing to do with food
or pet animals or eating chicken and mutton. People can eat whatever they want and how much
ever they want.
Q. Is there a link between a person’s immunity and COVID-19 transmission?
Ans: Coronavirus is one of the weakest family of viruses. The deaths caused so far or people
affected could have been ones with less immunity like children or the elderly. Sometimes, the
virus enters a person’s lungs and causes pneumonia. People with vulnerable immunity like the
elderly succumb to this. For young people with good immunity, the effects of the virus may not
be too strong but if you are someone with comorbid conditions like diabetes or cardiac disease,
or if you are on immunosuppressive drugs, then the risk of infection is severe.
Q. Are there any home remedies to treat COVID-19?
Ans: Home remedies and treatment other than allopathy is not proven science. The best thing is
precaution only. You must keep away from a patient who coughs and sneezes. If you are
coughing, you need to cover your face with a mask and not spread the droplets around. COVID-
19 spreads through droplets.
Q. Are antibiotics effective in preventing and treating the new coronavirus?
Ans: No, antibiotics do not work against viruses, only bacteria. The new coronavirus (2019-
nCoV) is a virus and, therefore, antibiotics should not be used as a means of prevention or
However, if you are hospitalized for the 2019-nCoV, you may receive antibiotics because
bacterial co-infection is possible.
Q. Do vaccines against pneumonia protect you against the new coronavirus?
Ans: No. Vaccines against pneumonia, such as pneumococcal vaccine and Haemophilus
influenza type B (Hib) vaccine, do not provide protection against the new coronavirus. The virus
is so new and different that it needs its own vaccine. Although these vaccines are not effective
against 2019-nCoV, vaccination against respiratory illnesses is highly recommended to protect
- March 25, 2020
Protecting yourself against COVID-19
Guidelines by the World Health Organization specify that one of the ways to reduce the risk of infection is by regularly and thoroughly cleaning one’s hands with an alcohol-based hand rub or washing them with soap and water. Regular washing becomes important as the virus tends to be viable from hours to more than a day on different surfaces that are regularly touched with hands.
Washing with Soap
The grime on our hands contains innumerable viruses and bacteria. Washing with water without using soap helps reduce the amount of microbes but does not remove most of the virus and bacteria completely. Using soap, therefore, becomes far more effective in removing microbes.
Viruses such as coronavirus, influenza-causing viruses, Ebola, Zika have their genetic material encased in a layer of fat called the lipid envelope. Soap molecules are pin-shaped with a head that is waterloving (hydrophilic) and a tail that is oil-loving (oleophilic). Being oleophilic, the tail portion of the molecule tends to have an affinity for and ‘competes’ with the lipids in the virus envelope. Since the chemical bonds holding the virus together are not very strong, the long oleophilic tail gets inserted into the envelope and tends to have a ‘crowbar’ effect that breaks the lipid envelope of the virus. The tail also competes with the bond that binds the RNA and the
lipid envelop thus dissolving the virus into its components which are then removed by water.
Alcohol-based Hand Sanitisers
Like soap, the alcohol present in hand sanitisers dissolve the lipid envelope, thus inactivating the virus. In addition, the alcohol also tends to change the shape or denature the mushroom- shaped protein structures that stick out of the lipid envelope. The mushroom-shaped protein structures help the virus to bind to special structures found on human cells and enter the cells. To be effective, the sanitisers should contain at least 60% alcohol.
Unlike soap lather, the alcohol does not come in contact with all parts of the hand. So care needs to be taken to use sufficient sanitiser to increase the coverage. Unlike water, alcohol run does not remove the dead viruses from the hand. While a sanitiser can quickly reduce the number of microbes, it does not get rid of all types of germs, and is “not as effective when hands are visibly dirty or greasy”. Using a Mask
Medical masks help prevent the spread of coronavirus infection. If worn properly, masks may be effective in preventing transmission of coronavirus. An article published in the Journal of the American Medical Association (JAMA) says there is no evidence to suggest that masks worn by healthy individuals can help prevent infection. But a 2010 study says: “Mask wearing was associated with reduced secondary transmission and should be encouraged during outbreak situations.” Even the World Health Organization says wearing a medical mask is “one of the prevention
measures to limit spread of certain respiratory diseases, including novel coronavirus (SARS- CoV-2), in affected areas”. 14 Transmission through droplets from coughing and sneezing is one of the major routes of virus spread. When worn correctly, a mask can reduce the risk of inhaling droplets containing the virus. With many studies showing that people infected with novel coronavirus transmit the virus even before symptoms show up, it may be prudent to wear a mask especially when the virus is spreading in the community. In a country like India, maintaining at least one metre distance can be a challenge, especially when there is no way of knowing who is infected till such time the person starts showing visible symptoms.
The WHO says that you should maintain at least 1 metre (3 feet) distance between yourself and anyone who is coughing or sneezing. This is because when someone coughs or sneezes they spray small liquid droplets from their nose or mouth which may contain virus. “If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease,” says the WHO.
Avoid Touching Eyes, Nose and Mouth Hands can pick up viruses as they come in contact with many surfaces. It can then transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and can make you
Practise Respiratory Hygiene Cover your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately.
- March 25, 2020
According to Raman. R. Gangakhedkar, head of the Epidemiology and Communicable Diseases-I
(ECD-I), Division of ICMR, there are two ways of going for vaccine preparation — either you look at the sequences of the gene which then may lead to development of antibodies, or you actually have the strain and then you try to develop a vaccine which is always an easier option. He said Indian scientists have managed to successfully isolate the COVID-19 virus and about 11 isolates are available, which is a prime requisite for doing any kind of research related to viruses and developing the vaccine. 11 Internationally, several institutes and pharmaceutical companies are in various stages of developing the vaccine with some set to go on clinical trials soon.