The COVID-19 pandemic has shaken the world and brought about drastic changes in our lives. As each wave is hitting stronger than the other, there is an increased demand for COVID tests and vaccines. With cases increasing day by day, there is a lot of pressure on labs and diagnostic centers to give out the test reports immediately, so that a person can start with the treatment and medications if tested positive. Also, to get tested, people would have to be physically present in the testing center, waiting in queues, exposing themselves to viruses, and increasing the risk for the people around them too. According to medical experts, the results must be given quickly, normally within 24 hours, to prevent the transmission of the virus. And delayed test results lead to further delay in treatment.

To avoid these problems and reduce the burden on the labs and diagnostic centers, the Indian Council of Medical Research (ICMR) given its approval for the COVID-19  Home Testing Kits. These Home Testing Kits are easily available in pharmacies and are one-stop solutions for all the problems with the traditional COVID tests.

What are self-test COVID-19 Rapid Antigen Kits?

These are Rapid Antigen Tests (RATs) that are available with the required device along with accessories to test oneself at home. These self-tests can be used to detect both symptomatic and immediate contacts of confirmed cases, as per ICMR guidelines. These over-the-counter self-testing kits do not require a prescription.

A positive test result should be considered as a true positive & does not need reconfirmation by the RT-PCR test.

Negative results must be combined with clinical observations, patient history, and epidemiological information. Symptomatic individuals identified negative by Rapid Antigen Test (RAT) should be linked with RT- PCR test facility and subsequently get tested by RT-PCR to rule out COVID-19 infection. In the meantime, such individuals will be urged to follow home isolation and treatment as a negative report on RAT may not be true negative in some cases.

Who can use the COVID-19 Home Testing Kits?

The test can be used on people who display symptoms of COVID-19 or are high-risk contacts of positive patients. The COVID-19 home test can be used on people who are 18 years of age and above, and even as young as children who are 2 years of age, when the samples are collected by an adult.

What are the contents available in the self-testing kits?

In each self-testing kit, there is an instruction for use leaflet, all the required testing materials, and a biohazard bag for disposal. The testing materials include a nasal swab, test card, and an extraction tube filled with an extraction solution along with Cap.

How to use the COVID-19 Rapid Antigen Self-test  Kit?

Before testing yourself, pick a comfortable spot to take the test. After finalizing the place, wash your hands or sanitize them thoroughly. Also, ensure that the surface on which the kit will be placed is cleaned and disinfected. After opening the contents of the kit

• Remove the swab from the package. Do not touch the soft end with your hands or anything else.
• Insert the swab gently into your nostril about 2-4 cm or until resistance is met, 
• Roll the swab 5 times inside the nostril
• Use the same swab and repeat this process in the other nostril
• Place the device on a clean, flat surface
• Peel off the aluminum foil from the top of the extraction solution tube
• Insert the nasal swab sample into the extraction solution, and then mix the swab 8 to 10 times
• Squeeze the swab by the side of the extraction tube and break the swab at the breakpoint, remove the remainder of the swab and mix well
• Place the dropper cap tightly onto the tube and add 4 drops (100uL) into the sample well
• Start the timer and wait for 15 mins for the results to show up.

How will I know  I have tested positive?

The test will take 15 – 20 minutes to show accurate results. If both the control band “C” and the test band “T” marked on the testing card are developed, the result is positive. If only the control band “C” is developed and the test band  “T” is not developed, it means that the result is negative. If neither the control band nor the test band develops, or if only the test band develops without the control line, it means that the test is invalid.

How to dispose the COVID-19 Antigen Rapid Test Kit?

Whether the results are negative or positive, one must dispose of every item from the kit. After using the kit, put the test device,  swab, and the extraction tube in a biohazard disposable bag and put it in the bin.

What are the disadvantages of the Home Testing Kit?

One of the biggest disadvantages of the self-testing kits is the reliability. Though these home tests yield quick results and minimize exposure to the virus, there are chances of the result being negative or invalid if the sample is not being collected correctly, or the swab getting contaminated, which also leads to inaccurate results. Hence, if the home test results are negative and the person still displays symptoms of COVID-19, one must follow up with their healthcare provider for further advice and stay in isolation till confirming test results are received.

These Rapid Antigen COVID-19 Home Testing Kits are helpful in the early detection of the condition. While self-testing, it is extremely important to follow the instructions of your healthcare provider carefully. Although it’s a game-changer during this time, it is important to understand that it is a screening test and to be used as an aid in the diagnosis of SARS-CoV-2 infection and cannot replace the confirmatory testing method. So, positive or not, always get in touch with a medical health expert and follow their advice for more information and quick recovery.

Introduction

Though people have started receiving COVID-19 vaccine doses, it is believed that we have to face a great amount of time combating this virus as the vaccine will take a long time for the vaccine to produce a prominent effect, while the pandemic carries on. Till then, people should anticipate that multiple restrictions of the COVID-19 pandemic will be continued for some time as we will have to co-operate with the authorities to diminish transmission of COVID-19 infection. It is believed that you will probably be required to continue adorning a mask and keeping a physical distance from each other while in public for quite a few coming months, even after you receive the COVID-19 vaccine.

No clear change evident for the near future

Everyone must realize that there will be no “instant change” in our community because of limited vaccine production and high demand. Hence, our lives won’t be shifting back to our predetermined notion of “normal” anytime shortly.

Also, vaccines are being given on a priority basis to forefront healthcare workers and the high-risk elderly population. But in a country like India, there are not sufficient vaccine doses available, to meet the required demand.

In addition to the above constraints, some vaccines need “ultra-cold temperature facilities” with -80°C freezers for their storage, which is a challenge for some economically less-developed territories. This situation reflects that facilities having the capacity to store massive quantities of the vaccine properly will be required, and then equally distribute it to every area of a state. The COVID-19 vaccine will need two doses, 3 to 4 weeks apart, as with the majority of other immunizations and for this to be accomplished appropriately, strict public health tracking would have to be in place to ensure people recognize accurate timings to receive their second dose after receiving the first dose.

No more ‘old normal’

Experts believe that there is still no real-world data available to ascertain the safety and effectiveness of the COVID-19 vaccines with complete surety. As of current knowledge, it is likely you could be protected from the symptoms of the disease, but it “might not protect you from getting infected and transmitting the infection. This means that we still need to adhere to the same preventive protocols.

The long road ahead

The duration of effectiveness of the current COVID-19 vaccines is also not clear, unlike the vaccines for other viral diseases, which provide life-long immunization. It is thought that with this coronavirus vaccine, if you get it once, your immunity will leave sooner or later, matching other flu conditions.

However, there is a silver lining to the dark cloud of this virus. It doesn’t seem to transform at a rapid rate, like influenza. It means that it won’t require regular development of new vaccines.

However, “patience” is the need of the hour as it will take months for the COVID-19 vaccine to become available freely for a majority of the population. Hence, people must not assume at this juncture that they won’t be needing to wear masks after a couple of months. Instead, people should accept that they still need to follow preventive norms for COVID-19 in terms of face masks and physical distancing for the next 4 to 6 months.

What you can and cannot do after getting your COVID-19 vaccine shot?

Drives for coronavirus vaccination have been initiated all across the globe. In India, over 2 lakh people have been vaccinated as of now and more stages are already in motion to immunize elderly individuals, individuals with co-morbid conditions, subsequently the younger population. At present, vaccination is the only good way of accomplishing herd immunity and will give the authorities and all the people at large, an estimated time by when things would be improving.

However, vaccination does not promise a total end to the pandemic. The vaccines are still experimental, and there is no reliable evidence to support their effectiveness in a “real-world” scenario. Again, mass inoculation and rates of prevention also depend on the number of people getting the vaccine, and the doses accessible for use. Thus, the resumption of a total pre-COVID lifestyle won’t be so relaxed even if vaccines make life easier. Following is a list of actions you can safely perform, and the ones you cannot even after getting vaccinated

1) You can’t throw your mask away at this moment

2) You cannot consume alcohol for 45 days

A vaccine can only perform in the presence of a strong and healthy immune system. For the same reason, it has been recommended to people to avoid consuming alcohol and certain things that can make immunity weak for some days. Alcohol is alleged to destroy the functioning of the immune system and make a person incapable of developing adequate elicitation of an immune response after receiving the vaccine dose. Hence, as per the expert opinion, people should avoid alcohol consumption for at least 45 days after their vaccination.

3) You can resume caring for COVID-19 patients

Caregiving for COVID-19 patients can be initiated by the doctors and health care workers who receive their entire vaccine doses (In most cases, both the doses). Hence, vaccination has been prioritized for the frontline-healthcare workers, doctors, and indispensable staff.

While basic precautions will still need to be followed, with COVID immunized records, you will have faint chances of getting infected from direct exposure to patients, and relieve the anxiety of their loved ones.

4) You will still be required to follow physical distancing

5) You will still be required to avoid public places

Vaccination won’t give people a license to stroll or meet in large numbers- at least at the start. Till an ample proportion of herd immunity is reached, there will be an abundant number of non-immunized people who, if infected, can transmit it to other people.

Introduction

The mutation of viruses

The genetic material of SARS-CoV-2 is a ribonucleic acid (RNA) composed of over 30,000 units. Among numerous RNA virus families, the coronaviruses carry the largest genetic material. The majority of other RNA viruses are composed of about 10,000 units.

When any genetic material reproduces — be it the smallest viruses to humans — random errors (or mutations) occur. While higher organisms possess the mechanism to correct these errors, viruses and especially the RNA viruses do not contain any such mechanisms. The majority of mutations are harmful, but such viruses are never seen. Only those mutations that provide some careful advantage result in the development of novel viral variants.

Why is the new variant of SARS-CoV-2 from the United Kingdom causing fear?

Three things are accumulating at present which is causing fear concerning the UK variant:

• It is swiftly replacing other versions of the SARS-CoV-2 COVID-19 virus
• It carries mutations that disturb virus parts which are probably important
• Some of those mutations have at present been presented to elevate the virus’s ability to infect cells in laboratory investigations.

There is extensive concern that these mutations may end the role of currently used tests in detecting the virus, make it more threatening, or let it escape the vaccines. However, till now, no evidence exists which proves any of the above worries. In any case, these variants were diagnosed by currently available RT-PCR tests.

Said so, there is clear evidence that this variant is more contagious. Patients getting infected with this variant produce more virus in their nose and throat, which leads to more shedding of the virus and more chances of transmission from one person to another. Though these variants seem not to be more lethal, being more contagious means that there would be higher numbers of severe infections and deaths, which is currently a cause for worry.

Why should people not panic?

The majority of professionals believe that vaccines presently in development and use would also work on the variant viruses.

Will the vaccines work against the new variant?

All leading vaccines, available in the UK and elsewhere, where the variant is spreading extensively, are capable of developing an immune response against the existing spike. Vaccines enable the immune system to attack several different target sites on the virus, hence despite a mutation of a single spike, the vaccines should still be effective.

How far has it spread?

The discrete mutant (named B.1.1.7) of SARS-CoV-2 was recently identified in the UK. The two earliest variants of this viral lineage were collected on September 20 and 21 from Kent and Greater London respectively. By December 15, this family grew to 1,623 viruses in London and other regions of the UK including Scotland and Wales, and then in Europe and later in Australia (4 from Australia, Denmark, Italy, and The Netherlands). On Christmas eve — the cases of these variant viruses more than doubled to 3,575; majority from the UK, but also being reported from France, Ireland, Israel, Hong Kong and Singapore.

Data suggests that cases in Denmark, Australia, and The Netherlands came from the UK. A similar variant even appeared in South Africa which shared several mutations of the UK variant, but seems not related to this one.

Has this phenomenon occurred earlier?

Yes. The virus that was detected first in Wuhan, China, is different from the virus that is found in the majority of the places in the rest of the world. The D614G mutated variant emerged in Europe in February and became the leading form of the virus, worldwide. Another mutated strain, called A222V, spread throughout Europe and was associated with Spanish patients, traveling in summer.

What do we know about the new mutations?

Viruses of the European line have gathered 23 mutations across 5 genes versus the original SARS-CoV-2 strains. Of these, there are 17 non-synonymous and six synonymous mutations. Notably, eight of the 17 non-synonymous mutations, are present in the protein that permits the virus to attach to and enter human cells. (Spike Protein)

• The N501Y mutation in one of the principal contact residues in the receptor-binding domain (RBD) of the spike protein increases its affinity for the ACE2 receptor. The N501Y change is also associated with increased infectivity and virulence in animal models. Both these mutations were earlier observed independently, but have come together in the UK variant viruses, resulting in a virus form that spreads more rapidly than before.
• The P681H mutation in the site of the cleavage between the S1 and S2 domains of the spike protein stimulates entry into vulnerable cells and surges transmission.
• Another mutation – an H69/V70 deletion, where a small portion of the spike is deleted – has appeared many times before. It has been suggested that this mutation elevates infectivity by two times in laboratory experiments. The same research suggests that the deletion produces antibodies from the blood of survivors which are less effective at countering the virus.

Does it make the infection more deadly?

No present evidence indicates that these mutations produce deadlier forms of the disease, but, it needs to be watched. Also, just growing transmission would be sufficient to create troubles for the health care system. If the new variant is capable to infect more people rapidly, it would mean that an increasing number of people would necessitate hospital treatment at a single reference point.

Can such mutated variants spread in India?

• Though India ceased all air-traffic from the UK and other European countries and increased surveillance at airports to stop importing this highly transmissible form of virus variant, such variants could develop within India with ease. In any case, India has reported more than 10 million confirmed cases and as per an estimate, 150 to 200 million people are already infected.
• A rapidly spreading variant called 501.V2 arose in South Africa and portions of the N501Y mutation of the UK variants have not been reported in India, yet, but viruses with the P681H mutation began showing up in July itself and currently 14% of SARS-CoV-2 spreading in India transmits this mutation. Though these viruses are chiefly reported from Maharashtra, cases have also been detected in West Bengal. One more such mutated form can easily transform the current state of the pandemic in India to the state of the UK, which is a cause of grave concern.
• The conditions thought to be conducive for the development of the UK variant are present in India also. Immunodeficient patients, who become chronically infected with SARS-CoV-2, stay positive for 2-4 months as compared to the typical 2-3 weeks.
• Sequencing of the viral genetic material from such patients has shown remarkably large numbers of changes. Viral genetic diversity from patient-to-patient is known to increase after plasma therapy, in immunodeficient patients, frequently used for treating such patients.
• Poor nutritional status is an established cause for weak immunity and clinicians in India have testified chronic infection in such patients.
• As of 9^th January 2021, the number of people in India who have tested positive for the new mutated COVID-19 strain has reached 90.

It is normal, if you face side effects from COVID-19 vaccines, as a matter of fact, from any vaccine. COVID-19 vaccines are the earliest ones to be developed from mRNA technology. Despite being highly effective, these vaccines also bear a possibility of causing a visible immune response (termed as “reactogenic”), leading to side effects.

These side effects are characteristic of inflammation brought by vaccines and are a symbol that your body is developing an immune response to the vaccine. Some vaccines are more reactogenic while some people may experience worse reactions versus others. The side effects of COVID-19 vaccines resemble those experienced after receiving any other vaccine.

What side effects are likely to occur after the COVID-19 vaccination?

Though side effects may differ with the type of COVID-19 vaccine, the traditional side effect is tenderness at the injection site. You may also come across other side effects such as tiredness, headache, muscle and/or joint pain, chills, and perhaps fever. These side effects will normally be felt for a couple of days, and maximum for a few days.

Will you experience the same side effects after each dose?

Since COVID-19 vaccines come in two doses, the varying response can be noticed. As per evidence, side effects were more frequently felt after the second dose in clinical trials.

Can side effects be more prominent in elderly and/or co-morbid patients?

No—actually, side effects have been less commonly seen and have been less severe in adults older than 55 years after vaccination, as per the clinical trials.

Do children experience side effects from COVID-19 vaccines?

The side-effect profile of COVID-19 vaccines in children is not yet understood completely.

How would you ensure that your side effects are normal?

The details of side effects will be explained to you at the time of vaccination and you will also be given the details as to when you should consult a doctor.

You can consult your doctor about taking over-the-counter medications, such as paracetamol if you have pain or discomfort at the injection site. You can also try the following measures, to relieve your pain and discomfort:

• Apply a clean and damp cloth over the site.
• Perform frequent movements with your arm, where you have received the shot.
• Consume lots of fluids and dress casually, if you have a fever.

When to consult your doctor?

It is advised that you should contact your doctor if the inflammation at your injection site increases after 24 hours, or in case, your side effects are a cause of worry and are not disappearing even after a few days.

How will you ensure that you are experiencing side effects and not symptoms of possible COVID-19 infection?

The side effects of the vaccine usually commence within 12 to 24 hours after getting vaccinated. However, it may be tough to differentiate between symptoms and side effects, if you get infected between vaccine doses. If you experience side effects that continue even after 48 hours, you should consult a doctor.

Is it possible for me to contract COVID-19 between doses?

Yes. Hence, each one must continue wearing masks, follow social distancing norms, and engage in frequent hand washing.

The first dose won’t give total protection, and it takes approximately seven days before you will achieve a full protective level of immunity after your second dose that occurs in about 95% of vaccine receivers. You could develop COVID-19 if you get exposed to SARS-CoV-2 before this period. Even after receiving both doses, it will still be vital to continue practicing public health saving strategies stated above, until the pandemic is brought under control.

Can you catch COVID-19 from the vaccine?

No, it is not possible to catch COVID-19 from the vaccine, but it is indeed possible to have developed COVID-19 and not realize until you get symptoms until you get this vaccine. The most vital symptoms to look out for are:

• a new continuous cough
• a high temperature
• a loss of, or alteration in, your normal sense of taste or smell

Though a minor fever can happen within 2 days of vaccination, if you carry any other COVID-19 symptoms or your fever lasts for a prolonged duration, quarantine yourself and get tested.

Can you go back to normal activities after having your vaccine?

Yes. You should be able to restart routine activities as long as you feel well. If your arm is predominantly sore, you may find it difficult to lift heavy objects with that arm. If you feel fatigued, rest, and avoid performing complex tasks.

Will the vaccine protect you?

The COVID-19 vaccines that have been approved for use have demonstrated a reduction in the chances of getting COVID-19 disease in individuals who have taken the vaccine. Each vaccine has been tested in more than 20,000 individuals in multiple countries and is shown to be safe. However, like all medicines, no vaccine is 100% effective, so you should continue to take recommended precautions to avoid infection. Some people may still get COVID-19 despite having a vaccination, but this would be less severe.

Concluding Remarks

• Side effects may resemble symptoms of flu and even disturb your ability to perform routine activities, but normally they disappear in a few days.
• In the case of the majority of current COVID-19 vaccines, you will need 2 shots for them to be effective. Even if you develop side effects after the first shot, contract the second shot, except in cases where your doctor tells you not to get a second shot.
• It takes time for your body to build protection after any vaccination. COVID-19 vaccines that require 2 shots may not protect you until a week or two after your second shot.
• Everyone needs to continue using all the tools available to help stop this pandemic as we learn more about how COVID-19 vaccines work in real-world conditions. Cover your mouth and nose with a mask when around others, stay at least 6 feet away from others, avoid crowds, and wash your hands often.

Lately, we’re seeing and listening about COVID-19 vaccines day in and day out. But how many of us know how do COVID-19 vaccines work? Very few. Here’s all about COVID-19 vaccines, the number of doses required to fight the virus and how it is going to benefit you and the world. 

How does the COVID-19 vaccine work?

Germs are all around us – both in our environment and inside us. When disease-causing germs/micro-organisms enter our body, it leads to sickness and in some cases even death. This is the time when the body creates its defense with the immune system which leads to the formation of antibodies. These antibodies are the soldiers in your defense system that are produced in response to viruses’ antigens which are an important part of the immune system.

Once the antigen-specific antibodies are formed, they work with the rest of the immune system to kill the virus and stop the disease. When the body is exposed to the same virus more than once, the antibody reaction is much stronger and more effective than the first time so the memory cells can pump antibodies against the virus and can fight it.

Once you get a hang of it, it is easier to understand how the COVID-19 vaccine works. These vaccines contain the weakened parts of the antigen that triggers the immune system to act up and form antibodies. Now, newer vaccines contain the blueprint of antigen, rather than the antigen itself. Regardless of it, when it is injected into a person, it doesn’t make the person sick, but it triggers the immune system to produce antibodies and fight against these antigens when the person comes in contact with it. In this way, the body is prepared to defend and fight a particular disease-causing virus in the future. When someone is vaccinated, they are protected against the virus. However, there are a few exceptions to it. For example, people who are immunodeficient i. e. people who are suffering from HIV or Cancer cannot be vaccinated.

Vaccines not only protect you but also people who can’t get vaccinated by achieving herd immunity where a maximum number of people get vaccinated to eradicate the virus.

How many doses of the COVID-19 vaccine are needed?

Many COVID-19 vaccines are being developed and authorized in many countries. Each of these vaccines requires a different number of shots for it to be effective. The two authorized and recommended vaccines require two shots at an interval; while the one in the trial phase in the US requires one just shot of vaccine to prevent COVID-19.

However, in India, vaccine trials are under different stages of finalization. However, vaccination for COVID-19 in India is voluntary. It will only be provided to the priority group i. e. the healthcare workers and frontline workers. In India, two doses of vaccines are required, 28 days apart to complete the vaccination schedule.

For vaccines like Moderna and AstraZeneca two doses are given at an interval of 4 weeks. For Pfizer, those two doses are given 3 weeks apart.

Benefits of the COVID-19 vaccines

To prevent coronavirus diseases, vaccines are the best hope for 2019. With scientists coming up with vaccines with the highest measure of accuracy and countries approving the same, we are getting closer to making this world a better place! The experts continue to study the effects of COVID-19 vaccines to date and they have derived a few benefits of the same. COVID-19 vaccines are not 100% effective yet. Hence numerous dry runs are conducted before distributing it officially in any country. However, we are getting there and there are still many benefits recorded when it comes to controlling the spread of COVID-19 with effective vaccination.

                    
These benefits are as follows:

• COVID vaccines help you create an anti-body response without having to become sick with COVID-19
• It keeps you from getting COVID-19.
• Even if you get COVID-19, it prevents you from becoming seriously ill or developing serious complications.
• Getting COVID-19 might also help people around you to be safe from the disease. Since it is a contagious disease, COVID-19 vaccination help people – especially the ones who are at a high risk of getting infected from severe illness.

The above mentioned is the information on COVID-19, its working, doses, and benefits. While the world is getting prepped up for the most effective vaccine, till then everyone needs to hang in there and be patient. Let’s not forget that basic sanitization, social distancing, wearing masks is still paramount and is equally effective in bringing a healthy change till everybody is vaccinated.