1. 5G: China expresses ‘concern, regret’

Can’t have bloodshed on border, good relationship in other domains: Jaishankar

China on Wednesday expressed “concern and regret” at India’s move to not include Chinese telecommunication firms among the companies permitted this week to conduct trials for the use of 5G technology.

External Affairs Minister S. Jaishankar, speaking at a Global Dialogue Series event in London, reiterated India’s view on Wednesday that it is “not realistic” to have good relations in other domains when there was tension on the border. Mr. Jaishankar did not specifically mention the 5G issue, but said broadly on India’s view on the relationship: “I can’t have friction, coercion, intimidation, and bloodshed on the border, and then say let us have a good relationship in other domains. It is not realistic.”

On Tuesday, the Department of Telecommunications (DoT) gave permission to several Telecom Service Providers (TSPs) to conduct 5G trials, and did not include Chinese companies Huawei and ZTE. “The applicant TSPs include Bharti Airtel Ltd., Reliance Jio Infocomm Ltd., Vodafone Idea Ltd. and MTNL,” the announcement said, adding they had “tied up with original equipment manufacturers and technology providers which are Ericsson, Nokia, Samsung and C-DOT” while Reliance Jio Infocomm will conduct trials using its own indigenous technology.

Reacting to the move, the Chinese Embassy in New Delhi said in a statement it “express[es] concern and regret that Chinese telecommunications companies have not been permitted to conduct 5G trials with Indian Telecom Service Providers in India”.

“Relevant Chinese companies have been operating in India for years, providing mass job opportunities and making contribution to India’s infrastructure construction in telecommunications,” spokesperson Wang Xiaojian said.

He said moves to “exclude Chinese telecommunications companies from the trials” would “harm their legitimate rights and interests”. “The Chinese side hopes that India could do more to enhance mutual trust and cooperation, and provide an open, fair, just, and non-discriminatory investment and business environment for market entities from all countries, including China, to operate and invest in India.”

At Wednesday’s dialogue, Mr. Jaishankar said the relationship was “going through a very difficult phase, because in violation of agreements and understandings of many, many years, the Chinese have deployed a very large part of their military on, and close to, the Line of Actual Control, without explanation, and they continue to be there”.

Mr. Jaishankar noted it had been one year since the LAC crisis began, on May 5, 2020 with reports of tensions then starting in the Galwan Valley and Pangong Lake.

He said China’s “actions have disturbed peace and tranquillity”, including leading to bloodshed in Galwan last June, and India “has been very clear that peace and tranquillity on the border areas is essential for the development of our relations”. The disengagement process was completed in some areas but one year on is still ongoing in others, and both sides had not yet come to the de-escalation part.

On Friday’s phone call with his Chinese counterpart Wang Yi, the External Affairs Minister said both sides had discussed their mutual interest in cooperating on tackling COVID-19 at a time when Indian companies have placed many orders to source supplies from China amid the current crisis.

‘Very laudable’

He told Mr. Wang that “many of our companies are ordering stuff from China and we are encountering difficulties in logistics, so please take a look at it which is something which we would appreciate”.

“After our conversation things did move,” he said. “Some of our airlines got quicker approvals, the logistics chain is flowing, and that is something which is very laudable.”

5G Technology

• Features of 5G Technology:
  • Millimeter wave spectrum: The 5G networks will operate in the millimeter wave spectrum (30-300 GHz) which have the advantage of sending large amounts of data at very high speeds because the frequency is so high, it experiences little interference from surrounding signals.
  • Upgraded LTE: 5G is the latest upgrade in the long-term evolution (LTE) mobile broadband networks.
  • Internet speed: In the high-band spectrum of 5G, internet speeds have been tested to be as high as 20 Gbps (gigabits per second) as compared to the maximum internet data speed in 4G recorded at 1 Gbps.
    
    
    • 5G network speeds should have a peak data rate of 20 Gb/s for the downlink and 10 Gb/s for the uplink.
  • Bands in 5G: 5G mainly work in 3 bands, namely low, mid and high frequency spectrum — all of which have their own uses as well as limitations.
    • Low band spectrum: It has shown great promise in terms of coverage and speed of internet and data exchange however the maximum speed is limited to 100 Mbps (Megabits per second).
    • Mid-band spectrum: It offers higher speeds compared to the low band, but has limitations in terms of coverage area and penetration of signals.
    • High-band spectrum: It has the highest speed of all the three bands, but has extremely limited coverage and signal penetration strength.
• Hurdles in Rolling Out 5G Technology:
  • Enabling critical infrastructures: 5G will require a fundamental change to the core architecture of the communication system. The major flaw of data transfer using 5G is that it can’t carry data over longer distances. Hence, even 5G technology needs to be augmented to enable infrastructure.
  • Financial liability on consumers: For transition from 4G to 5G technology, one has to upgrade to the latest cellular technology, thereby creating financial liability on consumers.
  • Capital Inadequacy: Lack of flow of cash and adequate capital with the suitable telecom companies (like Bharti Airtel and Vodafone Idea) is delaying the 5G spectrum allocation.
• Utility of 5G Applications: Combined with IoT, cloud, big data, AI, and edge computing, 5G could be a critical enabler of the fourth industrial revolution.
  • For India: 5G networks could improve the accessibility of services such as mobile banking and healthcare, and enable exponential growth in opportunities for unemployed or underemployed people to engage in fulfilling and productive work. For this Government has rolled out enabling policies.
• 5G Enabling Policy:
  • India’s National Digital Communications Policy 2018 highlights the importance of 5G when it states that the convergence of a cluster of revolutionary technologies including 5G, the cloud, Internet of Things (IoT) and data analytics, along with a growing start-up community, promise to accelerate and deepen its digital engagement, opening up a new horizon of opportunities.
    • It aims to reach 100% teledensity, high-speed internet highways and delivery of citizen-centric services electronically.
• Global Progress on 5G:
  • Global telecom companies have already started building 5G networks and rolling it out to their customers in many countries:
    • 5G had been deployed in 50 cities in the United States.
    • South Korea has rolled out 5G to 85 cities.
    • Japan and China have too started 5G mobile service on a trial basis.

2. Centre alone can identify SEBC: SC

‘States can only make suggestions to the President or the statutory commissions’

The Centre alone is empowered to identify Socially and Educationally Backward Classes (SEBC) and include them in the Central List for claiming reservation benefits.

“The President (that is the Central government) alone, to the exclusion of all other authorities, is empowered to identify SEBCs and include them in a list to be published under Article 342A (1), which shall be deemed to include SEBCs in relation to each State and Union Territory for the purposes of the Constitution,” Justice S. Ravindra Bhat, whose opinion was concurred by Justices L. Nageswara Rao and Hemant Gupta on the five-judge Bench, held.

Justice Bhat said the States could only make suggestions to the President or the statutory commissions concerned for inclusion, exclusion or modification of castes and communities to be included in the List.

The Central List is to be the “only list” for the SEBC.

“Once published, under Article 342A (1), the list can only be amended through a law enacted by Parliament, by virtue of Article 342A (2),” Justice Bhat said. “In the task of identification of SEBCs, the President shall be guided by the Commission (National Commission for Backward Classes) set up under Article 338B; its advice shall also be sought by the State in regard to policies that might be framed by it,” the court said.

“If the commission prepares a report concerning matters of identification, such a report has to be shared with the State government, which is bound to deal with it, in accordance with provisions of Article 338B. However, the final determination culminates in the exercise undertaken by the President (i.e. the Central Government, under Article 342A (1),” the court clarified.

However, “the President’s prerogative as far as the identification and inclusion of SEBCs in the List would not affect the States’ power to make reservations in favour of particular communities or castes, the quantum of reservations, the nature of benefits and the kind of reservations, and all other matters falling within the ambit of Articles 15 and 16”.

National Commission for Backward Classes: 102nd Constitutional Amendment

National Commission for Backward Classes – As earlier, National Commission for Scheduled Castes under Article 338 looked into complaints and welfare measures that pertain to Scheduled classes, Anglo-Indians as well as Backward classes.

Also, Article 340 of the Constitution provided for President to appoint Commission for Backward Classes, which until the passage of 102nd Amendment was not done.

The Amendment introduces Article 338 B, which gives constitutional status to the National Commission for Backward Classes.

Key Provisions of the act

• Insertion – The Amendment Act seeks to repeal the National Commission for Backward Classes Act, 1993 and insert Article 338B in the Constitution in order to set up the constitutional body, besides inserting a new provision through Article 342A to provide for Parliament’s approval for every inclusion into and exclusion from the Central List of OBCs.
• Composition – The Commission will consist of a chairperson, a vice-chairperson and three other members by the President by warrant under his hand and seal.
• National Commission for Backward Classes would not encroach upon the rights of State governments as they would have their own backward class commissions and their own lists of castes who belong to OBC. The NCBC would recommend only to the central government regarding inclusion or deletion of a particular caste in the list.
• The Central and state governments will be required to consult with the NCBC on all major policy matters affecting the socially and educationally backward classes.
• It is the duty of the commission to investigate and monitor how safeguards provided to the backward classes under the Constitution and other laws are being implemented and also evaluate how effective these safeguards are.
• Power – It has the power to probe specific complaints regarding violation of rights. In doing so, the commission has the powers of a civil court while investigating or inquiring into any complaints. These powers include: summoning people and examining them on oath; requiring production of any document or public record; receiving evidence.
• Object – The Commission is in charge of working towards improving the socio-economic condition of Other Backward Classes and also evaluating the progress in development at the Centre and state level.
• Annually, it shall present the President of India with reports that will include their
  recommendations on the implementation of protection, welfare and socio-economic measures that should be taken by the Centre and states.
• The President shall then lay down these reports in Parliament along with a memorandum explaining the action taken or a proposed move on the recommendations.
• Definition of SEBCs- It also seeks insertion of clause (26C) under Article 366 with a modified definition viz. “socially and educationally backward classes” means such backward classes as are so deemed under Art. 342A of the Constitution.
• The Act states that under Article 342A, the President has the power to specify the socially and educationally backward classes in the various States and Union Territories. He may do this in consultation with the Governor of the concerned state. However, a law of Parliament will be required if the list of backward classes is to be amended.

Purpose/object

The National Commission for Backward Classes is expected to remove the split between center and state reservation lists and bring about more transparency in the implementation of laws.

The existing commission under Article 338A did not have the powers to hear complaints from OBC members like the SC/ST commissions did, and in that sense, a constitutional authority will ensure it has more power.

The Commission will lead to better coordination and management of issues relating to betterment and improvement of conditions of the backward classes in India.

3. ‘INSACOG shared inputs on variants’

Warning of COVID-19 case surge due to mutants conveyed to govt., says scientist

The Indian SARS-CoV-2 Genome Sequencing Consortia (INSACOG) of scientists, spanning 10 labs across the country, and involved in sequencing genomes of coronavirus samples in different States, had been giving regular updates on the threat from new strains to the government, said a senior member of the group.

“The INSACOG members have meetings every alternate day. Whatever the results of analysis that emerge from the threat posed by new strains is shared with the National Centres for Disease Control and being a Health Ministry [body] is naturally shared with government,” Rakesh Mishra, Adviser, Centre for Cellular and Molecular Biology, Hyderabad, told The Hindu.

Dr. Mishra retired as the institute’s Director in April and since has been a scientific advisor there. “This system has been in place for most of this year, since the INSACOG system has been put into place,” he said.

In an interview to the news portal The Wire on Tuesday, Dr. Mishra said that warnings of an increase in cases from the increasing prevalence of new variants were conveyed to the government channels that eventually could likely have made their way to the Prime Minister’s Office.

At a press meeting on Wednesday, Health Ministry officials said that information on genome sequencing had been shared with States twice in February 2021, four times in March 2021, and again four times in April.

In a video conference with States, the Union Health Ministry said it was informed about the current status of Variants of Concern and new mutants and “stressed on increased and stringent public health interventions”.

The current surge in cases could be correlated with the rise in the B.1.617 lineage of SARS-CoV-2, popularly known as the “Indian variant” of the coronavirus, the officials added.

Dr. Mishra, in response to questions from The Wire, agreed that India’s political leadership should have been more communicative about the risks that events such as political rallies and religious gatherings posed, in the way of crowding, and transmission of newer infectious variants getting magnified.

4. Small businesses, MSMEs to get relief

RBI asks lenders to allow individual and small borrowers more time to repay debt, cites second wave

The Reserve Bank of India on Wednesday announced measures to protect small and medium businesses and individual borrowers from the adverse impact of the intense second wave of COVID-19 buffeting the country.

In an unscheduled address, RBI Governor Shaktikanta Das unveiled a Resolution Framework 2.0 for COVID-related stressed assets of individuals, small businesses and MSMEs and also expressed the central bank’s resolve to do everything at its command to ‘save human lives and restore livelihoods through all means possible’.

Eligibility criteria

Considering that the resurgence of the pandemic had made these categories of borrowers most vulnerable, the RBI said those with aggregate exposure of up to ₹25 crore, who had not availed restructuring under any of the earlier restructuring frameworks (including under last year’s resolution framework), and whose loans were classified as ‘standard’ as on March 31, 2021, were eligible for restructuring under the proposed framework.

In respect of individual borrowers and small businesses who had already availed restructuring under Resolution Framework 1.0, lenders have been permitted to use this window to modify such plans to the extent of increasing the period of moratorium and/or extending the residual tenor up to a total of two years.

In respect of small businesses and MSMEs restructured earlier, lending institutions have been permitted as a one-time measure, to review the working capital sanctioned limits, based on a reassessment of the working capital cycle and margins.

Credit support

To provide further support to small business units, micro and small industries, and other unorganised sector entities adversely affected during the current wave of the pandemic, the RBI decided to conduct special three-year long-term repo operations (SLTRO) of ₹10,000 crore at the repo rate for Small Finance Banks. The SFBs would be able to deploy these funds for fresh lending of up to ₹10 lakh per borrower. This facility would be available till October 31.

In view of the fresh challenges brought on by the pandemic and to address the emergent liquidity position of smaller MFIs, SFBs are now being permitted to reckon fresh lending to smaller MFIs (with asset size of up to ₹500 crore) for onlending to individual borrowers as priority sector lending. This facility will be available up to March 31, 2022.

State governments

To enable the State governments to better manage their fiscal situation in terms of their cash flows and market borrowings, maximum number of days of overdraft (OD) in a quarter is being increased from 36 to 50 days and the number of consecutive days of OD from 14 to 21 days, the RBI said.

Separately, Mr, Das asserted that though the impact of the second wave was ‘debilitating’, it was ‘not insurmountable’. “We do not expect any broad deviations in our projections,” he added.

5. Roche gets emergency-use authorisation for COVID drug

Firm gets nod to market the product locally with Cipla tie-up

Roche India on Wednesday said it has received emergency-use authorisation (EUA) from the Central Drugs Standards Control Organisation for antibody cocktail (Casirivimab and Imdevimab) indicated for treatment of mild to moderate COVID-19.

The EUA will enable Roche to import the globally-manufactured product to India, where it has a partnership with Cipla to market and distribute the same. The approval was based on the data filed for the EUA in the U.S and the scientific opinion of the Committee for Medicinal Products for Human Use (CHMP) in the European Union.

Roche said the antibody cocktail is to be administered for the treatment of mild to moderate COVID-19 in adults and paediatric patients (12 years of age or older, weighing at least 40 kg) who are confirmed infected with SARS-CoV2 and at high risk of developing severe COVID-19 disease.

“Neutralising antibody cocktails like Casirivimab and Imdevimab can play a role in the fight against COVID-19,” said V. Simpson Emmanuel, Managing Director of Roche Pharma India. “This outpatient treatment will be complementary to the ongoing vaccination drive and support our fight against the pandemic in India,” he added.

The drug will be available through leading hospitals and COVID treatment centres. Casirivimab and Imdevimab is approved at a combined dose of 1,200 mg (600 mg of each drug) administered by intravenous infusion or subcutaneous route. It has to be stored at a temperature ranging from 2 °C to 8 °C.

6. Editorial-1: A CT scan for COVID merits a word of caution

Going by data and the risk factors, its widespread use in diagnosing the infectious disease needs to be questioned

There are broadly three reasons why we perform tests in clinical medicine: diagnosis (what is the disease?), etiognosis (what caused a disease?), and prognosis (how will the disease evolve?). It is also important that the outcome of a test should guide treatment in some way, especially when it is being touted as being a monitoring test that provides unique information that cannot be obtained by easier means. Considering how widespread the use of computerised tomography (CT) scans of the thorax during the novel coronavirus pandemic has been, one would assume that the test would satisfy one, if not all the above criteria, for an accurate diagnostic test.

Data from studies

The Cochrane (previously known as the Cochrane Collaboration) pooled together all the available data from studies conducted over the last year to try and test the accuracy of CT scans in diagnosing COVID-19. It included 41 studies with a total of 16,133 participants. It was found that a CT scan accurately diagnosed COVID-19 in about 88% of individuals with a positive RT-PCR. Since an RT-PCR itself misses 30% of people who have COVID-19, a chest CT is likely to diagnose only 62% of all individuals having COVID-19, making it a relatively inaccurate test for diagnosis. In these difficult times in obtaining RT-PCRs due to overworked laboratory services, the use of a CT chest as a surrogate needs to come with a caveat: a normal CT chest does not exclude COVID-19, and, therefore, should not be a reason to come out of isolation, especially when the CT is done very early in the disease.

Mislabelling the cause

An accurate test for etiognosis would be one in which a result would make the cause almost certain. The same Cochrane review mentioned above found that when radiologists convincingly labelled a CT pattern as being consistent with COVID-19 disease, they mislabelled 20% of those who did not have the disease as having COVID-19, getting the etiognosis wrong in a significant proportion of individuals. Telling someone who does not have COVID-19 that they do have the disease has serious implications, leaving the real diagnosis undetected, and subjecting the individual to the psychosocial consequences of the knowledge that she/he has the disease.

The third reason that is often cited as being a reason to do a CT is for prognostication: a CT that appears worse is likely to lead to worse outcomes than a CT that appears better. Two comments need to be made in this context: the severity of lung involvement as seen on a CT is reflective of the status of the lungs at that point of time, and we know that this is a dynamic process, i.e., a limited involvement at an early stage could progress with time to a severe involvement; and a CT scan revealing severely affected lungs while oxygen levels remain high and unchanged is an extremely improbable event, suggesting that a CT is unlikely to give a treating physician more information than a simple tool such as an oximeter. It needs to be mentioned that in research settings, certain patterns of lung involvement (and not the mere quantum as reported by a score) have been associated with worse outcomes, but unfortunately, these have not been widely validated, and are not the reason why CT scans are presently being performed.

The risks

“What is the harm in getting a CT of the chest done?” is another argument one hears often. A study published in The New England Journal of Medicine in 2007 postulated that “0.4% of all cancers in the United States may be attributable to the radiation from CT studies”, and further speculated that the current estimate could be in the range of 1.5%-2%. This potential harm would have been clearly acceptable had this been a highly accurate and useful test. In addition to this risk to the individual undergoing the scan, there are risks to radiology technicians, staff and doctors that need to be accounted for. Moreover, considering the fact that CT scanners need to be kept in closed air-conditioned spaces, the risk of transmission of the virus at such centres cannot be ruled out.

As a physician treating COVID-19 disease over the past year, I have ordered CT scans for less than 1% of the patients whom I have treated. I have ordered them to evaluate the possibility of other lung diseases when two RT-PCR swabs were negative in patients whose symptoms were consistent with COVID-19 disease, in patients in whom there was a possibility of blood clots in the lungs when hospitalised, and to look for secondary infections in individuals who have been in hospital for a long time and can sometimes have new infections after being admitted for COVID-19. Intensivists have on occasion used CT scans to optimise ventilator strategies for individuals with severe COVID-19 disease. Indications outside of these should be the exception, not the norm.

Raise queries

So, if a physician asks that a CT scan be done, ask her/him a few questions. If it is being done for diagnosis, why not do an RT-PCR instead (or two RT-PCRs), considering the higher accuracy of the test? If it is being done despite COVID-19 being proven, ask whether a minimal involvement on the scan guarantees an uneventful clinical course, or whether a more than minimal involvement (when the oxygen levels are high, and the patient seems to be getting better) is a sign of impending deterioration. Ask whether treatment strategies have been proven to work better when guided by chest CTs (rather than clinical findings such as oxygen levels). If the answer to none of these satisfies you, consider the potential risks involved in getting that CT done, and feel free to make an informed decision.