According to health officials in Queensland, Australia, a new omicron lineage has been discovered in a tourist who arrived from South Africa.
The new lineage has about half the gene variations of the original and can’t be detected with typical screening, the state’s acting chief health officer Peter Aitken told reporters. It was found in a traveler who had arrived from South Africa and tested positive for the coronavirus on Saturday, he said.
According to a top WHO official, Omicron does not appear to produce more severe disease than prior COVID-19 variations and is “very unlikely” to entirely evade vaccine safeguards.
While much more needs to be studied about the novel, significantly mutated variety of COVID-19, preliminary research suggests it does not make individuals sicker than Delta and other strains.
“The preliminary data doesn’t indicate that this is more severe. In fact, if anything, the direction is towards less severity,” WHO emergencies director Michael Ryan said in an interview, insisting though that more research was needed.
“It’s very early days, we have to be very careful how we interpret that signal,” he said.
At the same time, he said there was no sign that Omicron could fully sidestep protections provided by existing COVID-19 vaccines.
“We have highly effective vaccines that have proved effective against all the variants so far, in terms of severe disease and hospitalisation,” the 56-year-old epidemiologist and former trauma surgeon said.
“There’s no reason to expect that it wouldn’t be so” for Omicron, he said, pointing to early data from South Africa where the variant was first detected that “suggest the vaccine at least is holding up in protection terms”.
Mr. Ryan acknowledged it was possible that the existing vaccines might prove less effective against Omicron, which counts more than 30 mutations on the spike protein that dots the surface of the coronavirus and allows it to invade cells.
But he said it was “highly unlikely” it would be able to evade vaccine protections altogether.
“We have to confirm if there’s any lapse in that protection, but I would expect to see some protection there,” he said.
“The preliminary data from South Africa wouldn’t indicate that we will have a catastrophic loss of efficacy. In fact, the opposite at the moment,” Mr. Ryan said.
In the fight against all COVID-19 variants, he said, “the best weapon we have right now is to get vaccinated.”
Two weeks after first being identified, Omicron has been found in dozens of countries around the world.
Early data from South Africa indicates that the new variant is likely more transmissible than previous variants, Mr. Ryan said, adding that this was not a surprise.
“When any new variant emerges, it will tend to be more transmissible, because it’s got to compete with previous variants,” he said.
Mr. Ryan said one could expect Omicron to gradually replace Delta as the dominant strain.
But he pointed out that Omicron had so far been seen spreading especially quickly in South Africa, where Delta had waned, and may just be “exploiting a gap in the transmission of Delta”.
There are also indications that Omicron is better at infecting people who have been vaccinated or already had COVID-19.
“There is some evidence to suggest that reinfection with Omicron is more common than it was with previous waves or previous variants,” Mr. Ryan said.
But, “we’re particularly interested in seeing not whether you can be reinfected with Omicron, but whether any new infection is more or less severe,” he said.
He said that, as the current COVID-19 vaccines aim to prevent severe disease but do not necessarily protect against simply contracting the virus, reinfections with mild or no symptoms were of lesser concern.
In any case, Mr. Ryan said, despite its mutations, the new variant was still COVID-19, and should be fought with the same measures, including vaccines, masks and physical distancing.
“The virus hasn’t changed its nature. It may have changed in terms of its efficiency, but it hasn’t changed the game entirely,” he said.
“The rules of the game are still the same.”
In an early investigation, researchers in South Africa discovered that Pfizer’s coronavirus vaccine (Covid-19) provided less immunity against the Omicron variation than to other major variants of the virus. When compared to the strain discovered in China almost two years ago, Omicron resulted in a 40-fold drop in neutralising antibodies produced by persons who had received two doses of the Pfizer-BioNTech SE injection in lab studies done at the Africa Health Research Institute in Durban.
Alex Sigal, the head of research at the laboratory, said that the loss of immune protection is “robust, but not complete” and that further efficacy studies are needed to appropriately take on board the exact extent of the vaccine’s impact in mitigating the disease caused by this new strain.
Speaking at an online presentation of the first reported experiments gauging the efficacy of the Pfizer Covid-19 vaccine against Omicron, Sigal said there will be “more breakthrough” of vaccine-induced immunity as he pushed the idea of getting booster shots to protect oneself against the new variant.
“A good booster probably would decrease your chance of infection, especially severe infection leading to more severe disease,” the Bloomberg news agency quoted the researcher as saying. “People who haven’t had a booster should get one, and people who have been previously infected should be vaccinated.”
Although these are early studies into the efficacy of existing vaccines against Omicron, the preliminary results have raised concerns that immune protection from vaccination or a previous bout of Covid-19 may be insufficient to stop reinfections or stem a fresh wave of cases and hospitalisations.
However, a top WHO official stated on Tuesday that there is no reason to believe that Omicron is more severe than previous strains or that existing vaccines will fail to protect against it. In an interview with AFP, Michael Ryan, the World Health Organization’s emergency director, said there is presently no evidence that existing vaccines will fail to protect those who get Omicron from the disease’s severe results.
A similar assurance was echoed on Tuesday by US infectious diseases expert Anthony Fauci, who said that Omicron is certainly not worse than the previous strains, including Delta.
However, both the experts agreed that more epidemiological data from around the world is needed to affirm scientific consensus on this. Since South Africa announced the discovery of Omicron on November 25, about 450 researchers globally have been working to isolate the variant from patient specimens, grow it in labs, verify its genomic sequence, and establish methods to test it in blood plasma samples, according to WHO.
Sigal’s laboratory was the first to isolate the Beta variant, a strain of the coronavirus that was identified in South Africa late last year. The latest research in his lab involved testing 14 blood plasma samples collected from a dozen people who had been given a second Pfizer-BioNTech shot about a month earlier to gauge the concentration of antibodies needed to neutralise or block the virus.
After a considerable decline in daily COVID cases yesterday, India observed a big increase in daily cases today. The government reported 8,439 new COVID-19 cases on Wednesday, up from 6,822 the day before.
After a considerable decline in daily COVID cases yesterday, India observed a big increase in daily cases today. The government reported 8,439 new COVID-19 cases on Wednesday, up from 6,822 the day before.
Meanwhile, 195 deaths in the last 24 hours took the death toll to 4,73,952. A total of 9,525 discharges in the same time span pushed the recovery total to 3,40,89,137.
The daily rise in new coronavirus infections has been recorded below 10,000 for 12 straight days and less than 50,000 for 164 consecutive days now.
The active cases count has declined to 93,733, comprising 0.27 per cent of the total infections, the lowest since March 2020. The national COVID-19 recovery rate was recorded at 98.36 per cent, the highest since March 2020, the ministry said.
A decrease of 1,281 cases has been recorded in the active COVID-19 caseload in a span of 24 hours, the data showed.
The daily positivity rate was recorded at 0.70 per cent. It has been less than two per cent for the last 65 days.
So far 129.5 crore COVID-19 vaccine doses have been administered in the country.
Prime Minister Narendra Modi launched three huge projects totaling Rs 10,000 crore in Gorakhpur, Uttar Pradesh, on Tuesday, which is the home turf of Chief Minister Yogi Adityanath. A fertiliser factory for Rs 8,603 crore, an All India Institute of Medical Sciences (AIIMS) worth Rs 1,011 crore, and an Indian Council of Medical Research-Regional Medical Research Centre hi-tech lab are among the projects (ICMR-RMRC).
“The program in Gorakhpur today is proof of the fact that nothing is impossible for new India when it becomes determined,” PM Modi said accusing the Opposition of neglecting development in the area. Taking a jibe at the Samajwadi Party, Modi said, “Today entire UP knows that the ‘red caps’ (Samajwadi Party) cared about ‘red beacons’ alone. Always remember that the ‘red caps’ are red alert for UP – they are bells to danger.” “They had nothing to do with your pain and issues. The ‘red caps’ want power – for scams and for filling their coffers, for illegal encroachments, for providing freedom to mafia,” he added.
Earlier in the day, he visited an exhibition of the development projects in Gorakhpur.
Chief Minister Yogi Adityanath said that only the BJP government had the courage to start the factory, “The inauguration program today is like a dream come true for the people in Eastern Uttar Pradesh. The fertiliser factory was shut in 1990 and until 2014, no one took the initiative to restart it. Only the BJP government had the courage to start it.”
GlaxoSmithKline Plc, a pharmaceutical business, said that their antibody treatment for Covid-19 is effective against the whole combination of mutations in the novel strain omicron.
The drugmaker in a statement said the tests done in-vitro against a pseudo-virus that recreates a synthesized version of omicron showed that sotrovimab, Glaxo’s antibody treatment, stands up to all mutations in the spike protein of the omicron variant and not just the key mutations. The tests included all 37 mutations identified to-date in the spike protein.
In the 24 hours leading up to 8 a.m. Tuesday, India registered 6,822 new covid-19 cases and 200 deaths. In addition, this is the lowest single-day jump in over 18 months. On Monday, there were 95,014, the lowest number of active cases in 554 days, and almost 10,000 persons had their cases closed.
On Monday, two cases of the Covid-19 Omicron variant were reported in Mumbai, bringing the total number of cases of the new coronavirus variation in India to 23. Two of the earliest cases were recorded in Karnataka, with one in Gujarat and another in Maharashtra following. Later on Sunday, seven instances in Maharashtra’s Pune area were reported, six of which belonged to the same family.
The burning issue right now omicron variant how much do we need to worry we have two cases which have been found in India the first case one of the cases a Doctor who has had no foreign contacts and no history of foreign travel. Does it mean that omicron is already in India that perhaps it’s possible it could have already spread or is it too early to press the panic button?
Dr. Padma: I think it is now three cases I just heard that the third case has been turn omicron positive in Gujarat from again and international travel so these cases are bound to come up now as regards the positivities in a person who did not have a travel history that’s a concern that you have raised now we also know that this been also from The Who that this variant is about three times more infectious so it certainly seems to have a precedence in terms of infectivity over and about the delta variant so obviously when there is a contact with an infectious person around so the infection rate would spread now as regards the fear versus being alert versus pressing the panic button when you press the panic button it leads to some kneejerk reactions and also to probably some of the actions which are undesirable what at this time we need is to be fearful because when you’re fearful you are on guard you’re alert and therefore you would take preventative measures so said that whatever information has come up it does see that it is definitely more transmissible and more infections and the who has also said that the reinfection rate means that those who had COVID infection in the past or who are vaccinated also are getting these infections with the omicron and there is also information from whatever the cases that have been seen so far it has been mild and the spectrum seems to be a little different in the sense that they did not record a loss of smell and loss of taste or more milder spectrum without the involvement grossly of lungs or oxygen lack or hospitalizations and certainly no deaths that’s encouraging said that though we know that the infections have not really gone on to involve very elderly immune compromised those individuals even a minor infection can lead to a major problem so giving it a blank statement that this would always remain mild we don’t know so we yet to see that’s number one to fear number two is that whenever the infections spread is because of mutations and when you have more mutations we do not know how the virus again behaves mutates and may lead to other variants so that’s another concern so therefore we have to take cautions that this infection should not spread.
Since you mentioned of this third case as well now this third case is a man who traveled to other country the second case of course is someone who’s had a travel history from South Africa I specifically talk about the doctor would the interpretation we would like to understand ma’am as Indians because there is of course a growing fear as far as this variant is concerned is it possible that it perhaps already is in India and that this mutation is not just important anymore it could have already spread?
Dr. Padma: That’s a concern that some of the biologist have raised we do have some information which has come from some biologists who say that this probably is already existent an you know all these kind of viral flu like features that are sometimes seen and in this weather and this season you have that very commonly seen that when supposing these people are tested then maybe you know this thing is there but that’s the kind of what you say is their thought on this that has come from certain biologists but as the we go by what the World Health Organization saying and what our ministry saying and so we’re going strictly by science so that part is not yet proven said that though you know that this is some amount of also trepidation that yes when you are exposed to someone who’s also traveled say in a congregation in a conference in meeting grounds the people coming from all parts and you know you do not know each and every person’s travel history in the last 15 days or a month and since the regulations and also the kind of you know what you call as limitations in our activities has sort of reason over the last couple of months so there is more travel there is more movement so it’s possible that the exposure may also have happened to another person who has had a travel history and you know that a large number of people also remained asymptomatic when they tested out some contacts which has come out in South Africa and other countries lot of contacts did not have many symptoms which is true for most of the viral infections so that may also be possibility of course there are people who also negating it saying that that’s not possible since the exposure was just couple of hours so I think it is too premature to make an assumption and be there but it really does not really lead to useful conclusions here at this point of term because as a very responsible citizens we should actually now stick to the precautions of being covid appropriate in our behavior wear the mask and get vaccinated I think these two arsenals are there with us instead of going into you neety gritty and small things about how somebody’s got infected what’s going to happen I think it’s in other hands to prevent something major happening.
As many others have also said that mask is like a vaccine in your pocket but you know speaking specifically of a vaccination what do we know about the variant and how it behaves with vaccination does it have the capability to override the immunity provided by vaccination and also I’d like to ask you this into correlation to the immunosuppressing elderly since of course as the head of the new row department of AIIMS you very closely work with that.
Dr. Padma: So the concern that cohort of group of people who are elderly and who immune compromise for whatever reason they’re on the suppressants they are on certain disorders their cancer patients or chemotherapy they’re taking steroid they have uncontrolled diabetics what have you or transplant patients whoever they are now this cohort remains out of concern because mild infections become major mild infections because severe and lead to severe consequences in this cohort so they’re always a concern now coming to vaccines I don’t think there is any kind of a doubt that vaccination will prevent us severity of an infection that stays whether it prevents being infected of course is probably not 100% certainly it may help but it is not going to 100% prevent from getting an infection like it is you know someone in one of the channels has given a very beautiful quote it is like wearing a helmet you know it wearing a helmet is not going to prevent you from all the exigencies and variations that may be happening when you’re driving but it will prevent a major head injury so the infection occurrence may happen but it’s going to really prevent the severity said that now it is those vaccines which have been developed against the spike protein and since we know that in the spike protein and omicron there are huge number of mutations therefore the manufacturers of mRNA vaccines are tweaking the vaccine so that it is now go into to anyhow but we have vaccines which are made under difference the preamble is different here so whether this is escape mechanism to these vaccines we don’t know yet said that there is also information which came from again World Health Organization which said that there is an immune escape property of omicron then maybe there are questions that the reason there’s a variant of concern therefore I would believe that getting vaccinated would be of absolute of paramount importance it is definitely going to help you in severity that’s what whether our vaccines are going to help in preventing omicron we don’t know the we still need to have that progress to understand and get that literature and information and there are people working on then the second thing is now this cohort whether it is omicron whether it is delta whether it is any infection this cohort of elderly an immune compromised are a precious cohort who definitely need more protection so they need to be definitely well guarded.
Since you speak of the elderly those who have other comorbidities let’s talk about you know the general population right now in fact not just right now from the past few months we’ve seen a huge debate around booster shots would you say that considering that we have a new variant which has so many about 50 mutations so that’s the least that we know of as of now given what’s happening in the world around us given that we are detecting cases in India as well do you think that that has expedited the need to give booster shots to a certain population at least at the earliest?
Dr. Padma: I believe this is being definitely conclusively being drawn out and I’ve also seen on the news that the ministry is also strongly contemplating that and the top sports of the science bodies are coming to conclusion very soon honoring this and there are of course parts of the world who are already going ahead and doing that yes I think a booster dose would be required for the individuals who would be act risk of developing a severe infection especially since six months hence there is some information in certain vaccine categories that the immunity wanes that again will definitely need to be proven across our part of the world we probably don’t have a huge robust data coming on that but then since this has come in we need to expedite our you know the kind of conclusive wait forward in terms of protecting these individuals so I think yes there is a role.
What about children ma’am you know ahead of the COVID task forces told us also in an interview that they are looking at providing vaccination to children also by the middle of next year but the question right now is that we have a new study which has come out South African experts medical experts have also verify that a large number of children under 5 have needed hospitalization cause of this new variant are children at a bigger risk this time should we look at vaccinating them as well at the earliest?
Dr. Padma: Yes so that is of concern it is true that the South African Medical Association has come out with this that they do have you know a rise in children under the age of five years with this variant infection although again they did not see that the infectious severity as such has been very extensive in that but certainly it’s of concern when you have a large group of very young baby is coming in with this infection it is of concern because it does not happen in at least the first wave on the second wave and certainly not in our part of the world so it is concerning and hence I think there will be a way forward even for these children but then I did hear that even the vaccinations for children are going to come on board probably even much earlier than what was earlier thought of but again as we speak since this kind of the rapidity with which information is also coming in from different parts of the world an our understanding and getting more robust evidence on which we can make decisions is also getting much higher and much more what I would say solid I think we should not have again as I said when you press the panic button there would be kneejerk reactions and that is I think that is what is being avoided by all responsible task forces and science and even the implementation agencies so I’m sure we will have a way forward very soon.
Right and the last question to you since you spoke of a way forward you said we shouldn’t press the panic button as you sign or what would be the word of advice you’d like to give people considering it’s the beginning of December and end of December is really when the peak tourist festive season also begins any word of advice you’d like to give people don’t panic but perhaps masking vaccination paramount?
Dr. Padma: You said it absolutely you hit the nail on the head so certainly non prioritized activities please don’t take up if you can avoid non prioritized activity I mean a gathering where it is purely of pleasure getaways gathering where it is not really required you can make do with a less number of people or equally you know postpone it for few months do that absolute essential travel is a must the essentiality depends upon your own survival your profession but unnecessary travel don’t do it we can definitely virtually meet and get going, and please mask up never have a mask down or unmask and go about as so the whole thing is you know don’t say all is well and go around saying that there’s no mask needed mask is absolutely essential your COVID appropriate behavior is a first arsenal get both shots of vaccines and whenever there is a booster dose which is which is you know given which is given two their cohort where it is ordained for please come forward and take it so get vaccinated get COVID appropriate behavior be responsible citizens you can do it.
If this variant is five times more lethal than the Delta variant and causes lower fatalities, it will prove to be a blessing in disguise, Dr Rajesh Malhotra, Chief of AIIMS Trauma Centre told Medically Speaking while discussing about the new Omicron variant that is wreaking havoc all over the world and has spread 21 cases in India now.
Read the full interview here:
What do we know till date about the Omicron variant and what does it mean for our country?
Dr Rajesh Malhotra: Covid is not yet over and somehow due to our optimism, the layman chose to ignore this fact. It is about evolution, like we evolved, the virus also continues to evolve into something more transmissible than Delta and brought together very concerning and worrying combination of mutations. We knew that the South African variant could escape immunity and infect people with antibodies and vaccination. The worry is that we are dealing with a virus that has got together two strong points of different strains and is emerging to be a formidable opponent which will be worse than Delta. But then it is very likely that this virus will become a predominant strain all over the world. Our concern is how is it going to behave as we have insufficient evidence and vaccination is not going to protect us from this completely. There is an immune escape that may not be a cause for panic but definitely needs surveillance.
One of the cases found in India had not come from foreign and neither had the infected person mingled with any carrier. Could it mean that the virus was already present? How are you interpreting the information which is pouring in now?
Dr Rajesh Malhotra: The only way to confirm the existence of a variant is by genome sequencing. In an article on genome sequencing, I wrote that whenever there is an outbreak, we need to look at need to see whether there is something new that has evolved to cause cluster of infection. There has been a similar thought in many of the countries where they had isolated the variant before South Africa declared it. There has been a geometric rise in the cases in South Africa but there has been a problem with the African continent three fold: Firstly, their testing has not been so large and widespread, secondly, their vaccination has been very limited and thirdly, large number of people in Africa are immunosuppressed.
There is an ethical debate when it comes to boosters. But do you think with this “horrible mutation” in consideration, the government should act faster on booster shots?
Dr Rajesh Malhotra: Data from South Africa has shown that those who were immunized had minor illness and those who were not immunized needed hospitalization, which means that an immunized person will be better after catching infection than the one not immunized. Therefore, we have to immunize all those who are yet to get their second dose and the reason is very clear that even if you have a breakthrough infection after immunization, you are not at high risk. Secondly, we have a high seropositivity rate among a huge population, so the thought process is that maybe a vaccine from different platform like nasal vaccine will be more effective. Thirdly, the breakthrough infections are largely to mRNA vaccines, which have hardly been given in India so we need to see whether the breakthrough infections are as common with Indian vaccines as they are with other. It is good to be cautious but I believe we may be overreacting till the time we have more data but we have to be on the guard because even if the hospitalizations increase, we do not want it to become uncontrollable. Even if it is destined to become predominant strain all over the world, if we handle a lesser dose at a time, we will get more time to react to it and see how it behaves and prepare accordingly. We also do not know about long Covid, so if everyone says that symptoms are very mild, and it does not cause fatalities or hospitalisations, we do not know how it is going to behave in the long run, whether it will cause disabilities or not. Considering everything, we have to protect ourselves and have greater surveillance and genome sequencing apart form accelerating vaccination drive.
What do we know about this virus’s ability to overcome the immunity provided by vaccination?
Dr Rajesh Malhotra: All the data on this has mainly come from South Africa which is its place of origin and the main vaccines used by them are mRNA by Pfizer, vaccines by J&J and AstraZeneca. You cannot extrapolate that data to the Indian population where there is large seropositivity. Secondly, this data does not pertain to the Indian vaccines. Not that it is totally ineffective, they said that it is 30 or 40 per cent less effective in preventing infection. We have always known and said that vaccines do not protect you from infections, but hospitalisations and death and ICU admission. It is only shot into prominence because of its high transmission and a rising number of infections. Hundred thousand people catch common cold, none of them panics, so what if even a small percentage starts needing hospitalization?
South African government says that a large amount of children need hospitalisations which has sent alarm bells all over the world, especially India. Would you say we have appropriate healthcare system if large number of infant and toddler hospitalisations are needed?
Dr Rajesh Malhotra: Firstly, I cannot see any reason why this cannot be fought by children. Secondly, there is a high seropositivity in children also. Thirdly, I would like to tell you that delta is highly infectious and there were hardly any households where one person got infected and the family did not. Same thing applies to children and only the children with major comorbidities like liver failure, childhood cancers died during the second wave. We are raising our guard because now we have been into the pandemic for close to two years. It is always said that a mask is a vaccine in your pocket which protects you against the virus just like the vaccines. Delta was a problem indoors and if this is five times more transmissible than delta, which is why you have all the more reasons to remain indoors. If this virus turns out to be more lethal than Delta, it will be a blessing in disguise because it has wreaked havoc all over the world and if it turns out to be infectious but does not kill, it will be a blessing. Therefore, we have to watch how it behaves among the unvaccinated, vaccinated, and those who were exposed to native virus. So we need to observe universal precautions at all costs. Do not go for rumors, only trust the data coming on from reliable and authentic organisations. Avoid all unnecessary gatherings and follow social distancing. Keep the vaccination drive in fast mode. We have been augmenting our infrastructure, we have to keep it ready but you must remember that it is counter intuitive for a virus to kill all its hosts. The virus is already five times more transmissible than delta and if it becomes as lethal or even worse, it will wipe out entire mankind which cannot happen. Therefore we can say that this virus has evolved itself to coexist with the mankind which will ultimately become and endemic, keep nurturing or feeding on a group of people. We will eventually have to vaccinate children. The only thing is that we do not know about the risk benefit ratio yet because very small number of children have actually dies due to pandemic but maybe there will be a time when there will be a vaccination for children while they are undergoing other vaccinations. But during the peak of the pandemic we always think that those who are not vaccinated remain vulnerable and death rate for children is much higher for adults than for children.
According to the city’s Covid-19 nodal officer, whole genome sequencing of a 71-year-old NRI who arrived in Gujarat’s Jamnagar city from Zimbabwe and tested positive for Covid-19 on December 2 found that the patient is infected with the Omicron variant. The patient’s samples were submitted to two different labs: one to Gujarat Biotechnology Research Centre, which found the Omicron variation, and another to NIV Pune. On Monday, NIV is anticipated to release its full genome sequencing findings.
This is the third case of Omicron found in India. Two persons in Karnataka, a 46-year-old doctor and a 66-year-old South African national, were discovered to be infected with the new type earlier this week.
In other news, the Centre has said that it anticipates the severity of the Omicron variant of coronavirus to be low in the country given the fast pace of vaccination and high exposure to the Delta variant. Speaking in the Parliament, Health Minister Mansukh Mandaviya on Friday highlighted that a decision on booster dose and Covid jabs for children will be taken on the basis of scientific guidance from experts.
Top genome scientists, meanwhile, have recommended a booster dose of the Covid vaccine for those above the age of 40 years with priority for high-risk and high-exposure populations, according to the weekly bulletin of Indian SARS-CoV2 Genomics Sequencing Consortium (INSACOG), a network of national testing laboratories set up by the Government to monitor genomic variations of the virus.
Addressing the crowd in Gorakhpur, PM Modi lauded the Yogi Adityanath government for taking up development projects in the state. ‘Beginning of a fertiliser plant & AIIMS in Gorakhpur is sending out several messages. When there is a double engine govt, then work takes place in double speed. When work is done with honest intentions, then even calamities can’t become obstacles,’ PM Modi said.