Talking about the third Covid wave, he said that the intensity of any wave in near future would be lesser than what the country witnessed a couple of months ago during the second peak in April-May 2021 and it may not affect the entire country.
Here are the excerpts of the interview.
Q. Have states started showing signs of third Covid wave amid rising Covid cases?
A. Surges of infections of SARS-CoV-2 are being observed now in a few states; these should be examined by the respective states as such surges could serve as early warning sign. With a viral pandemic of this magnitude, there is always a possibility for future waves. But I feel that the intensity of any wave in near future would be lesser than what the country witnessed a couple of months back during the second peak in April-May 2021 and it may not affect the entire country.
If there is an increase in the symptomatic cases, it could burden the healthcare system. Therefore, it is important to study the possibility of future wave with respect to the last waves. The second wave in India hit Delhi, Maharashtra and a few other states hard. Eighty per cent of the recorded infections during the second wave came from about 10 states. But there were some states which were not affected to any great extent at that time, which makes their population more vulnerable to catching infections during the next viral wave. But this time, good coverage of vaccination in these districts or states could prevent severe illness. In states, where we already had a devastating second wave, the population has had exposure to such an extent that the chance of getting symptomatic disease in large number is quite low. We should also remember that vaccination in these states has also gained momentum.
Another point, which is worth appreciating, is that within a state, there could be districts experiencing different spread and intensity of infection. Therefore, analysis of local data - at state level and even at district level - should guide local action.
Q. Does the Covid variant C.1.2 detected in South Africa and other countries pose any threat to India?
A. In India, the genomic surveillance initiative is named INSACOG, which is a consortium of 30 laboratories across the country including ICMR's to keep an eye on any new variant that could possibly lead to a surge in cases. These laboratories also track the new variants of concerns reported internationally. Any mutation that could lead to an increase in virulence, that could contribute to the greater or stronger attachment to the host cell, or could escape immunity developed through natural infection or post-vaccination, concerns us.
Q. Can the recently-detected MU variant evade the immunity?
A. As far as the two new variants -- C.1.2 and MU are concerned, it is too early to call them a variant of concern. We need to keep an eye at the community level infections for any indication of clustering, or severity of the disease among hospitalized cases or increased reporting of deaths from an area due to SARS-CoV-2 infections. All these observations per se indicate events of concern, requiring epidemiological investigation as well as genomic surveillance.
Q. Health Ministry has confirmed 300 cases of Delta plus variant. How do you see it ahead of looming third Covid wave?
A. Delta plus cases are increasing in number in the country but at a slower pace. There was a rapid spread of Delta variant during the second wave in a few states and in dense population area. What we need to be watchful about now is who is getting infected by Delta plus -- are they getting infected after receiving the vaccine and if yes, what is the severity of the disease in the vaccinated population. Importantly, what we are seeing in different states of India now is that most of the vaccine recipients, even after getting infected with SARS-CoV-2, are not progressing to the serious stage of the disease, neither do they require hospitalization. That is the advantage of Covid vaccine - they do not prevent transmission of infection but they do protect one from getting to a severe stage.
Q. How do you see the reopening of schools ahead of the third wave?
A. The fourth national serological survey has clearly shown that a substantial proportion, about 55 per cent, of the children have already been exposed to the disease and developed antibodies. Besides, we have seen that the chances of children developing severe disease or those requiring hospitalization are rare. So, I feel that we can safely reopen the schools. If the parents get vaccinated, and the teachers of the schools get vaccinated, other support staff of the school get vaccinated, the children will be safe. Besides, we need to reduce the crowding in the school-buses, and in the classrooms and also ensure hand hygiene and mask-use.
Schools may also think of including Covid Appropriate Behaviour, creating peer groups to promote the same and visible display boards with 'Dos' and 'Don'ts' within the school campus could be of help. It is very important for the children to be able to go to school now because that contributes greatly to their growth and future life opportunities. The more we keep the children away from school we are creating hindrances in the path of their long term development. States should therefore have their respective plans for opening of schools in calibrated fashion where state specific epidemiologic data as well as examples from other countries could guide pragmatic public health action.
(Avinash Prabhakar can be reached to firstname.lastname@example.org)
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