OPEN LETTER TO THE MINISTRY OF HEALTH AND WELLNESS – Can we prevent COVID-19?

The coronavirus pandemic is ravaging the whole world; with increasing number of cases on a daily basis and no approved treatment. The only option for many governments is total lockdown. I write this paper from Mumbai, India where a 21-day total country wide lockdown has been enforced from 25th March 2020. With over 500 positive cases nationwide and a few reported cases of community spread, the government is left with no other option. The lockdown in India is still sparing medical shops, grocery stores and essential services unlike in Mauritius where I have heard the lockdown is complete. The situation in India is quite difficult because of the population density which is 420/sq km, whereas China has population density of 145/sq km (1). And Mumbai, the financial capital of India has a density of 21000/sq km! With many people living in slums where the distance between houses or shanties is barely a few inches, quarantine itself may not work. Hence, we will have to be prepared to meet the unfortunate scenario of a barrage of infected cases overloading the fragile healthcare system.

Now if we look at Mauritius, the population density is quite high at 626/sq km despite the total population being far less than India and China. But the society is not structured around dense apartment buildings and there are no slums. With majority of population staying in independent houses; the quarantine and maintaining social distance can have huge impact on the corona virus spread among Mauritians.

Mauritius has an ageing population and about a third have concomitant diseases like diabetes and hypertension. People at high risk of severe illness from COVID-19 include people aged 65 years and above; people with underlying medical conditions like diabetes, hypertension, heart conditions, renal failure, liver failure, chronic lung disease including asthma, immunocompromised patients etc (2). The COVID-19 virus binds to a specific receptor

called ACE2 to infect lung epithelial cells. Hypertensive patients who are taking treatment with ACE inhibitors and angiotensin receptor blockers have increased ACE2 levels and hence are at risk. Although the research is ongoing and there is no clear evidence as yet but such patients need to be closely monitored if they get COVID-19 (3). Hence the palpable fear is very real for Mauritians and preventive measures are a must to prevent its rapid spread.

Once any infection like the COVID-19 virus enters a cell it replicates and grows inside; eventually the infected cell leaks the contents and virus into the lung tissues. Our immune system gets triggered and various cytokines are released by our body. Cytokines are the small signalling proteins produced by our immune system to carry out the chain of events required to fight off the infection. People with good immune system can fight off COVID-19 infection and are able to recover. Viruses can cause our defence mechanism to malfunction, depleting the ability to fight of the infection. Thus, another way of looking at fighting off the COVID-19 pandemic is to boost our immune system.

We have been working on making low dose cytokines; cytokines made in such a way that they can be taken orally and not via injection route. They stimulate our body to make innate cytokines naturally rather than injecting extraneous cytokines in the body, thus by-passing the side effects of injectable cytokines. In a true sense that they are just regulatory. We were inspired in making these cytokines by an Italian company Guna which is also making low dose cytokines for other purposes. They currently however do not make the cytokines we are making.

A few studies are underway to see effect of cytokines such as interferon beta and interferon a2b with anti-interleukin 6 along with other medications such as remdesevir (anti-Ebola drug), hydroxychloroquine (anti-malarial) lopinavir with ritonavir (anti-HIV) – 4 and 5. However, none of these can be used to improve the immune system as a preventive. The low dose cytokines we make can be used as a preventive measure by potentially improving the host immune system. It can also help in its treatment along with other drugs currently being used by boosting a person’s immunity. We are currently in the process of seeking approval for doing a small study. From anecdotal data on the cases we have done the response has been very good on a host of viral infections. Samples of our product can be made available to the government of Mauritius to do their own study on its effects on COVID-19.

As a preventive measure I am proposing to introduce cytokines. At best, it will boost the immune system, thus weakening the COVID-19 virus. It could be introduced in Mauritius immediately. It is available. At this point, Mauritius is in a desperate situation and it urgently needs to control the spread of the virus. There is no immediate miracle cure, so we have to rely on what is available as preventive measures. I am making a request to the Government of Mauritius to introduce cytokines as part of its treatment. We are offering our assistance. Kindly contact me if you need to discuss this further. Please act urgently to save lives in Mauritius.

References: 1.https://worldpopulationreview.com/countries/ Accessed on 25 Mar 2020 2.https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/people-at-higher-risk.html Accessed on 25 Mar 2020

3.https://www.healio.com/cardiology/vascular-medicine/news/online/%7Bfe7f0842-aecb-417b-9ecf-3fe7e0ddd991%7D/cardiology-societies-recommend-patients-taking-ace-inhibitors-arbs-who-contract-covid-19-should-continue-treatment Accessed on 25 Mar 2020

4.https://www.sciencemag.org/news/2020/03/who-launches-global-megatrial-four-most-promising-coronavirus-treatments Accessed on 25 Mar 2020

5.https://www.newsweek.com/cuba-drug-fight-coronavirus-us-sanctions-1493872 Accessed on 25 Mar 2020