It is imperative to reduce the cost of cancer treatment: Ramesh Ramadurai, MD, 3M India – ETHealthworld.com

Shahid Akhter, editor, ETHealthworld, spoke to Ramesh Ramadurai, MD, 3M India, to know more 3M collaborations that can improve and impact cancer care, besides cutting down on the costs in a big way.

How has the technological and infrastructural facilities impacted Bone Marrow Transplantation in India ? Every year nearly 20,000 Indian patients, including many children, who suffer from blood and solid cancers require bone marrow transplantation (BMT). However, only 2,000 of these patients are fortunate enough to receive this therapy, as the cost of bone marrow transplantation can vary from INR 10 Lakhs to 30 Lakhs. It is imperative to reduce the cost of cancer treatment while maintaining a stringent focus on sterilization and quality. It is indeed the need of the hour for us to address this issue.

What are the various technological advancement required for the better functioning of the facilities?Despite the increasing demand for bone marrow transplantation, the number of bone marrow doners in India is astonishingly low. India conducts stem cell transplant procedure for approximately 2,000 every year, while around 80,000 to 100,000 annual transplants are required to tackle the burden of blood cancers and fatal blood disorders. Finding a matching donor is very difficult. This option is exercised only after the alternative options have failed.

India has only about 400,000 donors registered on the bone marrow registry. Chances of finding a donor match are as low as 10% to 15% compared to the West where the chances of matching are as high as 60% to 70% due to higher rates of donations.

What are the major and significant developments in treating bone marrow cancer in the country? A bone marrow registry collects information on individuals willing and able to donate bone marrow and gathers the donor information into a database. In India, organisations like Datri are helping to create a pool of donors to help people who do not have blood-related donors by finding an unrelated match for life-saving treatment.

Infusion of a memory cell is another advancement. This involves taking out the cells, sorting the good cells and the memory cells or the fighting cells, which can fight infections, sorting them out, capturing them and putting them back into the body after giving the requisite chemotherapy. This is also called T-cell depletion with memory cell infusion. It is now available in India and is affordable.

Through this partnership with United Way Bengaluru and Sri Shankara Cancer Hospital and Research Centre (SSCHRC), how does 3M aim to foster accessibility for people from different sections of the society in treating cancer. 3M India was brought into the SSCHRC family through United Way of Bengaluru, and this is our second round of engagement with the hospital. Last year, 3M India had donated equipment for cancer research and diagnostics like the Sanger sequencer and QPCR, made enhancements to the childrens play area at the long-stay Lakshmi Childrens center with child-friendly wall graphics, and provided kitchen utensils and cooking counters for the resident families of paediatric cancer patients.

We have donated several critical equipments for the research labs which contribute to the successful treatment of the BMT patients. As on date the BMT unit at SSCHRC has treated and discharged 5 patients and currently 4 are undergoing treatment. This wing of the hospital is accessible by few staff nurses and specialists like Dr K N Nataraj who is the Chief of Adult and Paediatric Haematology at the hospital. For a successful bone marrow transplantation, there are several requisites, some of which include, successful donor matching, extremely technique-sensitive harvesting and transplantation processes and robust infection control. With this essential, life-saving equipment, the cost of the treatment will reduce to approximately 50% (between Rs 8-12 Lacs as against the actual cost of Rs 15- 30 lacs) and help the hospital treat many more cancer patients.

How do 3M India and Sri Shankara Hospital plan to take this initiative ahead in the future for the growth and enhancement of bone marrow transplantation in the facility? It is matter of pride for 3M India and United Way of Bengaluru that we are associated with SSCHRC, an institution at the forefront of providing comprehensive cancer treatment to the needy, through CSR interventions.

By complying with the Foundation for the Accreditation of Cellular Therapy (FACT) Guidelines, the BMT Centre will be a one-of-a-kind medical facility where people of all economic status can receive treatment. Being a growing facility, the hospital is committed to continuing its responsibility towards expansion of multiple hospital beds and medical care. We are inspired by the commitment of the doctors and Sri Shankara Board of Trustees, led by Dr. B.S. Srinath and other dedicated professionals who developed a multifaceted approach to establishment a state of the art, affordable cancer hospital that is accessible to all irrespective of caste, creed, religion, gender or socioeconomic status.

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It is imperative to reduce the cost of cancer treatment: Ramesh Ramadurai, MD, 3M India - ETHealthworld.com

COVID: How bad is the omicron variant? Q&A on what new research is telling us – The Denver Post

The new omicron variant is spreading fast. But research is beginning to catch up.

Because an early case was detected in San Francisco, local scientists have quickly started growing the virus in high-security labs at UC San Francisco, UC Berkeley and Stanford.

Using cell cultures, theyll soon learn how readily it transmits, whether it can dodge our defenses and outcompete delta. In mice, theyll study whether it produces illness that is severe or mild.

In one or two weeks, we will have a much clearer picture of what this variant is going to do to us, said Dr. Melanie Ott of UC San Franciscos Gladstone Institute of Virology and Immunology.

Meanwhile, South Africa studies have begun to offer a real-world glimpse of how much risk omicron poses.

The extent to which omicrons sudden spread is caused by immune evasion or more contagiousness or both is yet unclear. But as the variant expands into 17 U.S. states and at least 45 nations worldwide, heres what were learning:

Q: Is omicron more or less dangerous than delta?

A: A new small study suggests that omicron may cause less severe illness than previous variants like delta.

The best indicator of disease severity is the in-hospital death rate. A report this weekend identified 10 omicron-linked hospital deaths at two South African hospitals, representing about 6% of 166 COVID-related admissions. This compared to a 17% death rate at the hospitals among COVID-19 patients during previous waves of infections. However, this time it wasnt just elders who died; four of the deaths were in adults ages 26 to 36.

The same hospital said that the majority of COVID patients did not need extra oxygen, and far fewer were so sick that they were admitted to the ICU. Most discovered they were infected only after being admitted to the hospital for other health reasons. The average hospital stay was only 2.8 days, down from 8.5 days during infection with other variants.

Most of these patients were unvaccinated, although there were some vaccinated admissions, as well.

Can this be generalized given the younger population in South Africa, with very extensive prior COVID? Thats an uncertainty that will remain until we see much larger numbers of infections in older people.

South African Medical Research Council

Q: Whats the latest guess about how infectious it is?

A: In South Africa, about 3 to 3.5 new omicron infections are estimated to stem from a single case. In contrast, the reproductive rate of delta in South Africa and the U.S. was about 1.5.

If omicrons reproductive rate continues at around 3, this indicates a much larger threat, in terms of case counts, than delta. The size of the wave depends on the susceptible population.

Trevor Bedford, Fred Hutchinson Cancer Research Center in Seattle

Q: Will omicron overtake delta?

A: In South Africa, omicron has surpassed delta as the dominant strain. But delta was on the wane there, so omicron had an open field to run in. Omicron did not have to push delta out.

What we dont know is how well omicron will compete in an environment thats 99.9% delta, such as California.

Dr. Warner Greene, Director of Gladstone Institute of Virology and Immunology, UCSF

Q: If it outcompetes delta, and its milder, isnt that good news?

A: It would be great if omicron is always a mild virus. But we dont know that yet. It will take a month or so to learn the virulence of this variant, and whether it will replace delta.

Dr. Warner Greene

Q: Will my previous infection protect me?

A: Perhaps not. South African doctors are seeing an uptick in reinfections among people who tested positive for the virus at least 90 days earlier, suggesting that immunity acquired through natural infection is not fully protective.

Omicron is three times more likely to cause reinfection compared to delta, according to a Dec. 2 paper.

Juliet Pulliam, director of the South African Centre for Epidemiological Modelling and Analysis, Stellenbosch University

Q: Are vaccines protective against infection?

A: We dont yet know. In infected patients in one very small South African study, more than half were considered fully vaccinated, with two shots.

But its unclear how much time had passed since their inoculation. If it was more than six months, their antibody levels had waned.

These patients hadnt gotten boosters. Boosting creates a huge increase in antibodies much more than what is achieved after the second vaccine dose. Thats what is leading vaccinologists to hope that even if antibody levels start to decline, protection will last longer. Its starting at a much higher level.

Dr. Warner Greene

Q: How long will it take to design omicron-specific vaccines?

A: Vaccine makers Pfizer and Moderna say they can get one ready within 100 days. Making a new mRNA vaccinewill involve generating a new genetic sequence, based on omicron, and encapsulating it in a fatty substance such as a lipid.

This autumn, the vaccine companies have been doing dry runs, practicing all aspects of executing a strain change the preclinical research, the manufacturing, the clinical testing and the regulatory submissions so they are ready to respond quickly.

Journal Nature

Q: Then will we have to wait for new clinical trials and FDA approval?

A: The FDA told the Wall Street Journal that it is already in conversations about streamlining authorization for revamped vaccines. Agency officials have met with vaccine makers and are working to set guidelines for the type of data that will be needed to swiftly evaluate the safety and efficacy of changes to current vaccines.

Wall Street Journal

Q: Should omicron change how we celebrate the holidays?

A: Its probably best to avoid international travel. Its far better to fly domestically than take a long haul flight to Europe, Asia or Africa. And be careful about where you fly domestically. Dont fly into a hot zone.

But experts like Dr. Greene say their perspective is so different this December versus last year. My family and I are vaccinated, he said. I do not believe that Im going to die of this coronavirus. I dont believe my family will die of this coronavirus.

Yes, I may get infected. I might be sick for awhile. But I am really confident that Im not going to die. And that just changes my whole perspective. Were in such a better place.

Dr. Warner Greene

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COVID: How bad is the omicron variant? Q&A on what new research is telling us - The Denver Post