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19.5.21 The Hindu Editorials

🛑Millions of people wearied by the onslaught of the coronavirus have had to contend with a furious tropical cyclone that has left a trail of death and destruction before making landfall in Gujarat. Cyclone Tauktae swelled into an extremely severe cyclonic storm, dumping enormous volumes of water all along the west coast, and caused loss of life in Kerala, Karnataka, Goa, Maharashtra and Gujarat, before weakening overland. To thousands who had to be evacuated to safe locations, this year’s pre-monsoon season presented a double jeopardy, caught as they were between a fast-spreading virus variant and an unrelenting storm. Many coastal residents would have felt a sense of déjà vu, having gone through a similar experience last year, when the severe cyclonic storm, Nisarga, barrelled landwards from the Arabian Sea, pounding Alibaug in Maharashtra as it came ashore. The cyclones in both years spared densely populated Mumbai. The twin crises have, however, strained the capacities of multiple States, especially the coastal ones, although the impact of the storm was considerably mitigated by disaster response forces. Once again, the value of creating a trained cadre, supported by the defence forces in rescue and relief work, is seen. The heralding of the 2021 monsoon season by a cyclone comes as another reminder that the subcontinent is at the confluence of more frequent, extreme weather events originating in the Bay of Bengal and the Arabian Sea every year.

How well India is prepared to handle cyclones depends on developing greater expertise in forecasting and disaster mitigation, and crafting policies to increase resilience among communities. Last year, the India Meteorological Department (IMD) launched an impact-based cyclone warning system from the October-December season designed to reduce economic losses by focusing on districts and specific locations, and incorporating such factors as population, infrastructure, land use and settlements. The IMD also claimed that its accuracy of forecasts, for instance, in plotting landfall location, is now better. Together with ground mapping of vulnerabilities, this is a promising approach to avoid loss of life and destruction of property. The importance of precise early warnings cannot be overemphasised, considering that the Arabian Sea has emerged as a major source of severe cyclones, and their intensity is aggravated by long-term rise in sea surface temperatures linked to pollution over South Asia and its neighbourhood. Climate-proofing lives and dwellings is a high priority now, a task that warrants a multi-sectoral approach: to build sturdy homes of suitable design, create adequate storm shelters, provide accurate early warnings, and ensure financial protection against calamities through insurance for property and assets. Governments must rise up to the challenge.

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1.Contend With (Phrasal Verb)-to have to deal with a difficult or unpleasant situation.

2.Swelled (V)-to make something larger than normal.

3.Evacuated (V)-remove (someone) from a place of danger to a safer place. खाली कराया गया

4.Jeopardy (N)-danger of loss, harm, or failure. ख़तरा

5.Unrelenting (Adj)-without stopping. निरन्तर

6.Déjà Vu (N)-a feeling of having already experienced the present situation. पुर्वानुभव

7.Barrelled (V)-drive or move in a way that is so fast as to almost be out of control.

8.Pounding (V)-to hit heavily and repeatedly.

9.Ashore (Adv)-on land as opposed to at sea. तट पर, किनारे पर

10.Heralding (N)-a person or thing that proclaims or announces. घोषणा करना

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🛑The Indian Council of Medical Research (ICMR) has finally dropped its espousal of convalescent plasma therapy (CPT) as treatment for moderate COVID-19 in its latest guidelines. In its guidelines of April 22, CPT was already on its last legs, with the advisory recommending that it is advisable only in early moderate disease, or within seven days of symptoms. These updates flow from periodic reviews of medicines and treatment protocol by a task force of doctors and experts of the ICMR. Practising doctors are not legally bound to follow these recommendations to the T but are expected to circumscribe their treatments within the guidelines. Last year, the ICMR, in one of the definitive clinical trials in the world, demonstrated that CPT neither saved lives nor improved patient outcomes but was equivocal about it in public. This gave leeway to some States, particularly the Delhi government, which openly disavowed the ICMR’s findings, encouraging several doctors to put the onus on hapless caregivers to source such plasma from those who had recovered from the illness. The clamour for plasma had birthed its own kind of ecosystem. There were apps designed to connect donors to recipients, an inevitable black market, and, if the plasma did not seem to be working, the tendency was to blame the quality of plasma rather than recognise the futility of the treatment.

Last week, it took a letter by a clutch of concerned public health professionals to India’s Principal Scientific Adviser as well as results from a trial, published in The Lancet, spanning around 11,000 patients — that again found no benefit — to demote CPT. Further evidence is emerging that CPT may be contributing to the evolution of coronavirus mutations that, together, may have been the final nail in the coffin. However, this is not the end of the road for treatments with limited scientific basis finding a mention in the ICMR guidelines. Hydroxychloroquine and the anti-parasitic drug, ivermectin, continue to find a place for the treatment of mild disease despite a specific mention of “low certainty of evidence”. There is an argument that doctors, battling a disease that has so far defied a predictable treatment regime, cannot always observe the necessary clinical equipoise. Unlike doctors on the frontline, a collective of experts such as the ICMR taskforce, has the comfort and the distance to dispassionately assess evidence and be very specific with its recommendations. Publicising these at regular intervals serves to educate the public about the evolving nature of treatment and be better prepared as future patients and caregivers. This will work better towards easing the pressure on doctors as well as in improving trust in systems that are designed to offer the best possible expertise.

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1.Espousal (N)-adoption or support. समर्थन

2.Convalescent (Adj)-returning to health after illness or debility. स्वास्थ्य लाभकारी

3.On Its Last Legs (Phrase)-weak or in very bad condition.

4.Equivocal (Adj)-uncertain or questionable in nature. अस्पष्टार्थ, अनिश्चित

5.Leeway (N)-freedom to act within particular limits. छूट, स्वतंत्रता

6.Disavowed (V)-deny any responsibility or support for. इनकार करना, अस्वीकार करना

7.Onus (N)-something that is one's duty or responsibility. दायित्व

8.Hapless (Adj)-very unlucky or unfortunate. अभागा

9.Futility (N)-pointlessness or uselessness. निरर्थकता

10.The Final Nail In The Coffin (Phrase)-Another negative event or action that contributes to one's downfall or to something's failure.

-----------------------------------------with thanks to original source


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