Will there be any end to this virus?

Kakali Das

With the impending third wave and the uncertainties overit, these are the questions which we have all been asking ourselves – Is there any end to this Pandemic? Are we in an endless cycle of waves? Is this what the next few years are going to look like?  Especially, when we look at the news overseas, regarding how the other countries are now racing for their third wave, fourth wave, one wonders what the end point is!

Prof. K. Srinath Reddy, the President of Public Health Foundation of India (PHFI) and former Head, Department of Cardiology, AIIMS has informed the Odisha government that the third wave is now eminent. In an interview, he has said that there are some parts of our country that are witnessing a prolonged second wave, and in some parts, a lightly eruption of a third wave.

While there are countries claiming and aiming for zero Covid-19 cases, China having millions tested simultaneously in a matter of a few days, introducing concepts of lockdown to the world – Australia and New Zealand becoming fortress islands etc., but according to Prof. Reddy, we can’t completely prevent the ingress of the virus, and that however careful we’re, the virus would travel with someone or the other. What’s important, he says, is to restrain the virus from infecting a larger number of population and preventing them from various diseases and fatalities till the vast majority are vaccinated. As a result, even if it remains in our midst, it would nudge the virus to become milder over a period of time.

“It may take several decades to become as mild as the common cold virus, but certainly we can get a step down in terms of its virulence. Even if it becomes infectious in its variant form, if we protect our the people, it is unlikely to cause a serious amount of disease, but it can’t be completely eliminated from the face of the earth,” Prof. Reddy further said.

In terms of vaccines, he has said that we have potent vaccines available which are very effective to prevent the virus, the vaccines which can still be modified against the new variants, and therefore, if we have a huge amount of vaccination across the world, we are providing less opportunity for the virus to develop new variants. But in case of less vaccinated population, we are giving the virus a great opportunity to experiment and develop new variants, which can be quite problematic for the countries to handle.

“Yes, we will probably have a third wave. Most countries will too face the third wave, till they have higher levels of vaccination. We will have a third wave interms of cases, we may not have the third wave in terms of a huge number of deaths, because they might have acquired immunity by infection or vaccination by then,”said Prof Reddy.

Besides, the UN and WHO have been constantly concerned about the fact that, while the western countries, that have monopolised about 70% of the vaccine manufacturing, are now offering the third booster dose to its population, there are countries across Asia and Africa who have not received any doses at all – which is alarming. We saw that the Delta variant that is currently terrorising most of the countries have actually emerged out of India. It may be possible that the next scary variant might come out of Africa where the world has not shared vaccines with, and that could be a reason for worry. What the high income countries are not recognising is that if they let other countries have huge breakouts of infections, if the large number of population is vulnerable and susceptible, and providing opportunities for mutation easily, then those variants which emerge from there are likely to somehow sometime spread into these First World countries as well. It’s impossible to completely lock their countries out forever, they are bound to find the variant coming in, if not from India, then from South Africa, Peru or somewhere else. Therefore, it is absolutely important for the First World Countries, if not for altruism, but in terms of enlightened self-interest, to try and share the vaccines and get the entire world vaccinated.

Less than 10% of our population is fully vaccinated; there is a large number of people who haven’t even received one dose. The first task for the country is to protect the vulnerable sections and those with comorbidities. Whatever limited stocks we have are to be utilised to protect the vulnerable. If we scale up the production of the already available vaccines, as the government has been reiterating, in the next few weeks, we should be able to vaccinate the entire country with greater speed.

“Till we reach at least 80% of vaccination across the country, I do not think we can live with the assurance that we will not have either spikes coming up now and then, or even the possibility of larger waves, if we are careless enough to allow the virus to spread easily,” Dr Reddy said.

There will be a resurgence of the virus, and the numbers will surge if we give it a free run. It depends on our behaviour, and as we are entering a festive season, we are at the cusp again where there is a little bit of déjà vu. Besides, the Haryana government has allowed a gathering of maximum 1000 people including invitees and spectators during the Independence Day events. These huge gatherings which has been allowed in these events, followed bythe festivals immediately in the upcoming months, would break all hell loose. Navigating the festive seasons amidst the pandemic, in terms of restrictions, I think would, indeed, be challenging.

According to the ICMR Sero surveys, the cities like Delhi, Kolkata are better off, because more than two-thirds of that population including children are already showing signs of antibodies in their system, which one assumes they may have received from known to unknown carriers of Covid-19. In Delhi, people are currently eating at restaurants, visiting and thronging malls, partying and behaving as if nothing has happened, or suffering from amnesia (pun intended), in terms of how the country has suffered over the last few months.

Emphasising on the importance of antibody surveys, Prof Reddy said, “I really ought to reinforce the message that a very large number of people are susceptible even if they take the antibody surveys at face value, but we can’t take these surveys at face value, because all that they have done is detect the antibodies, and not measured their neutralising capacity. So, we are not sure even if their antibodies are currently protected or are likely to be protected in the short run. But, even if we take these antibody surveys at face value, there are a massive number of people who are still unprotected in the country. And, the moment we have the virus infecting most people, it can actually develop into new variants, and can even endanger people who have been vaccinated.”

To this, I want to add that Delhi, in the previous year, claimed that they had 55% Sero survey positivity, and that they had achieved herd immunity. But, then, arrived the Alpha variant and the cases started ascending, followed by the Delta variant which we have, in the name of ‘second wave,’ witnessed how savage it has been despite the claimed herd immunity.

So, we shouldn’t let our guards down, and remember that the best way of preventing it is by wearing masks, ensuring that we move in ventilated spaces and avoid large crowds till we cross, at least, the 80% vaccination rate across the country.

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