Tag: India Fights Coronavirus

Ashwani Mehta, an Indian Navy veteran and a social worker based in Lucknow, says India has learnt its lessons from past Covid waves and is positioned well to handle any health calamity

‘Hybrid Immunity Will Help Us Tackle A Fresh Covid Wave’

By LokMarg

Ashwani Mehta, an Indian Navy veteran and a social worker based in Lucknow, says India has learnt its lessons from past Covid waves and is positioned well to handle any health calamity

Covid-19 pandemic was a challenge not just for India but for the entire world. We indeed suffered a lot because of population density but a strong leadership at the centre and our robust medical research infrastructure helped us come out of the tragedy stronger. We not only developed an effective vaccine in record time but also produced and delivered serum to many countries.

As far as the new variant of the COVID -Omicron sub-variant BF.7 is concerned, we are well prepared and better positioned to handle any possible surge in future. The pandemic era taught us some lessons and the progress that India has achieved over the past few years has left the world astonished. India has set an example for generations to follow.

Looking at the situation in China, things have again started deteriorating due to a renewed surge. The Chinese authorities are reeling under the fresh wave and, in spite of trying to hide figures, a very high number of casualties.

Mehta says India has no reasons to fear a new surge

In comparision, India has no reasons to fear or to go on the back-foot as infection in India is currently under control. We belong to a generation that was left on the ground (mitti) to play… this helped us develop natural immunity. Post-Covid, a large part of our population has got vaccinated. Thus, we have among us a hybrid immunity – a combination of vaccination and natural immunity. As far as the backlashes of the new variant of the Corona virus is concerned, we are at safe. Therefore India is in a better position to fight the pandemic than China.

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Having said that, I request our fellow countrymen to get vaccinated and if they already have, get the booster dose. According to the ICMR study, 65 to 70 percent of the population was affected by the wave of corona that had come to the fore in India. In some states, the number was even higher. Experts believe that this vast spread has created herd immunity.

Some such studies have also come out where it is mentioned that due to both natural and corona vaccine, the immunity will remain effective for a long time. Most people in India have acquired this immunity through dual contagian. Yet, as a responsible citizen, I request every Indian to remain prepared to fight against all any probable calamities and contribute to the nation building.

As told to Rajat Rai

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India Preparedness On Covid

‘India Can Tackle Any Covid Wave Now; But A Surge Is Unlikely’

By LokMarg

Dr DK Gupta, MD of Felix Hospital, Noida, says while the world is worried about looming new Covid variant, India sits on a sweet spot to fight off any surge

Over the last three years, China has made many false claims with regard to Covid-19, its origin and its spread. Most of these assertions fell flat in reality. Initially, China claimed that the infections did not originate from their country, to ward off the blame for the pandemic. The result of such a denial was that its own people had to bear the consequence.

For their global image, they adopted an unyielding zero-Covid policy and made false declarations. They claimed that their vaccine (Sinopharm) was very effective. But even their allies did not trust them. Its efficacy was questionable, actually terribly low, and as a result we see the current wave of Covid hitting China and the world soon.

Of late, China ‘Zero covid’ is a flop — people aren’t getting basic amenities to fight the infection; hospitals are full of patients; there is shortage of doctors, medicine, blood and oxygen etc. People are now protesting against the government.

Spike of Covid cases in China is worrying for Indians too and there is growing concern if a repeat situation of 2021 second wave is looming. However let me assure everyone that India stands strong. Over 95% of the population has received the primary doses of Covid vaccine and 30% have got a booster. Another wave is unlikely as widespread infection during the previous Delta and Omicron waves has given a large section of Indians hybrid immunity. This will prove vital in fighting a fresh wave of infections.

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Incidentally, India may be at a better position than most other countries in terms of fighting a new wave or a new variant like BF.7. This BF.7 is a variant within the Omicron family of Variants of Concern (VoC). Many of the mutations seen in earlier lineages appear to be consolidating in the Omicron lineage, which allows it to evade pre-existing antibodies and makes it highly transmissible.

This is not a new virus. It is yet another Omicron family member. Therefore, the symptoms of Covid remain the same — fever, cough, shortness of breath, difficulty breathing, nausea, vomiting and diarrhea. We do expect more variants as different mutations get together.

We are much better prepared than we were during the Delta wave in April-June 2021 when there was low vaccination. I doubt there would be any big waves in India due to reasons mentioned above. This is not to say that we become complacent; we must stay vigilant because vaccines protect against disease not infection. And very large numbers of infections may lead to increases in the numbers of severe disease patients.

I doubt another wave would emerge in India and I am assured that Indians are better prepared than they were in previous waves, in case of another surge. We should stay cautious but not worry too much. This is because over 90 percent of adults in India have received two doses (primary series) of a vaccine, a large fraction of Indians have hybrid immunity, i.e. vaccine plus infection which works well against severe disease.

As told to Deepti Sharma

Read more: http://13.232.95.176/

Omicron, The Crafty Virus

By Jasdev Singh Rai

It would appear as if there is a central committee of viruses that meet, learn from their experience and adapt with new strategies. That is of course a metaphoric statement. Viruses are not meant to have brains nor a sense of social community, let alone a strategy team. But what has happened and has happened in the past with dangerous viruses, is not far from this myth.

The Omicron variant of the SARS-Cov-2 Virus is far less potent than its predecessors but more infectious, spreading like wildfire once it takes hold in a population. According to three studies quoted in the British Medical Journal, the infection rate is faster but hospitalisations rate is about 15-80% less than its first predecessor and even the Delta variant. It also lasts shorter, between two and seven days. Some people have almost no symptoms but found to have the Omicron virus on testing.

The studies were done in England, Wales and South Africa. The number of people needing intensive care and oxygenation is even lower. Deaths are far fewer than the first Covid wave.

However that is no reason to let the virus rip through society. India is beginning to see an exponential increase in Omicron cases. That is the pattern with this virus. It starts with a few cases, but then within weeks, there is a steep curve of number of people infected.

The three studies so far have different populations. The South African study is based against a background that over 70% of South Africans have contracted Covid-19 last year and then subsequently the Delta variant. They have developed a natural immunity as the number of vaccinated people are less than countries like UK or India.

Cheryl Cohen, the South African doctor from the National Institute for Communicable Diseases who did the study even declared that their study suggests a positive story with reduced severity.

The England and Wales studies were against a background of over 80% people having been vaccinated twice. The percentage of people with the third, booster vaccine dose, was lower when the study was conducted. The study shows that people with booster dose are least likely to have any serious illness from Omicron. Those with two doses are at slightly higher risk. But most people needing hospitalisation have been those who were not vaccinated. Britain has escalated its booster dose programme and has even declared that it will reach its target before the end of the year. Vaccinators were working during the holidays too.

The studies have implications for India. The number of triple jabbed people is not high. India’s hospital infrastructure needs a lot of investment and is no where near that of developed western countries.

ALSO READ: More Covid Questions Than Answers

As Omicron starts to spread, the number of people relative to number of hospital beds and doctors is again going to be highly unfavourable. Even if a mere 0.5% people become seriously ill in India, that is over a 5 million patients. Where is the infrastructure to deal with that?

Consequently, India needs to take precautions urgently. Many European countries who have only just finished second vaccination, have gone into full or partial lockdowns. Some countries require quarantine for visitors. These measures have not started in India. There is a general belief among people that the virus is less virulent and therefore will require less stringent measures. There have been demonstrations against Government lockdowns as a result.

The Coronavirus story is typical. A new strain of virus can be extremely virulent as it is with the original SARS-Cov-19. However after a few mutations, it either becomes extinct or finds a form that causes minimal reaction within the human body but also enables the virus to do what it wants. The virus simply needs a host, replicate and die.

It is the reaction by the human body that causes health problems with Coronavirus. Macrophages (cells of defence and clean up) react, cells die and the toxins produced overwhelm the body’s ability to get rid of them. Consequently the SARS-Cov-19 virus now has found a mutation that can slip by through most human defences, cause less disruption and cell death and therefore less toxin production.

Eventually it might end up being treated as another cold. That is beneficial to both the virus and human beings. It seems surrealistic to paint a picture of nature engaged as a silent mediator between a virulent virus and a determined anti-virus human race and finds a settlement that appears to be in sight. The virus becomes less dangerous and humans start tolerating it. However this is in fact mythology or fiction.

When a new strain of virus comes into human race, sometimes it can cause havoc. This was the case with Bird flu, the Spanish Flu (of 1918), Ebola and Zika virus and now the Coronavirus.

Some viruses in history are thought to have become extinct. While others have become so benign that they don’t pose any problem.

What actually happens is that the genetic code is not static. As it replicates, it continues to develop mistakes, changes, mutations etc. Some times the mutation can be deadly for the host, such as humans or an animal. Sometimes the mutations can be self destructive and the virus goes into extinction. Sometimes mutations can become benign and cause fewer symptoms.

Benign viruses can also suddenly develop a mutation that becomes deadly. The Omicron Coronavirus may be less dangerous now but as its genetic code, the RNA in the case of Coronavirus, continues to develop faults, changes and mutations, a future mutation from the Omicron could be fatal.

It will be best if the Virus disappears altogether. However that is unlikely. Coronavirus has already had hundreds of mutations. Some have caught the headlines because they were virulent. Many have disappeared. Others may be lingering in benign form in animals or even humans without symptoms. Any of these could mutate into dangerous ones.

The spread of viruses depends on several factors but mainly transmissibility. Some, like HIV, can only be got through direct sexual contact or fluid exchange. Others like Covid seem to be airborne too and can jump easily from one person to another. Some viruses transmit when the host is fully infected while others jump when the host is still asymptomatic.

Consequently, it will be silly not to take Omicron Virus seriously. There have been quite few other small epidemics and pandemics in the last 20 years. It will be equally silly not to be vigilant for new variants. The vaccines give us hope. Equally Government need to put in place rapid reaction response strategies in case a dangerous mutation evolves. In the war between viruses and humans, indeed between viruses and all species, there are no winners. It is a perpetual war that will carry on as long as life exists on earth.

Is India Prepared For 3rd Covid Wave?

By Amit Sengupta

Indonesia now is in exactly the same terrible and tragic situation as India was during the peak of the second surge. Australia is going for a lockdown, and even New Zealand, hitherto totally safe, is on high alert. With cases rising in thousands every day, Boris Johnson might once again take the UK down the drain if he opens up the lockdown on July 19, even while all is not well in Catalonia/Barcelona in Spain, among other EU nations.

Vice President Kamala Harris led a ‘pride rally’ recently without a mask. Americans in many parts are allowed to come out in the open without masks. However, with 50 per cent fully vaccinated, is the virus really “on the run”, as President Joe Biden so proudly claimed on Independence Day, 4th of July?

There is reportedly a ‘silent surge’ in many parts of America and it is worrisome. It is being largely attributed to clusters of unvaccinated people, including Trump-supporters ‘in denial’. A Georgetown University study reportedly found 30 clusters of counties, of which five are across the Southeast and Midwest, from Georgia to Texas, across Missouri, and parts of Oklahoma, Tennessee, Louisiana, Alabama and Arkansas, where the threat is real and looming large.

So how well is the Indian State with a new health minister at the helm prepared for the ‘third surge’, even as the second wave lingers on, and thousands care a damn in tourist spots, without masks or physical distancing?

Listen to the Covid Task Force head, Dr VK Paul, as reported by the Indian Express: “It is right that the graph (of the decline in the number of cases) has slowed down. It was earlier declining at a faster pace. It only shows that we cannot take the situation for granted. If it is around 35,000-37,000 cases per day, this is almost one-third the number of cases we saw during the first wave peak. The war is not over; the second wave is not over. It is perhaps more visible in some districts and two particular states and the Northeast, but it is still there. As long as this is still rising there, the nation is not safe…With a lot of effort and difficulty, we have reached a situation where cases are on the decline. The situation is bad only in a few districts. But all this can be snatched away from us because we have not contained the virus completely. If we give the virus an opportunity, and chains of transmission are launched…this is something we cannot afford…”

Indians banged thalis, frying pans, pressure cookers at 5 pm on March 22, 2021, following the call of Prime Minister Narendra Modi, even when the virus was just about spreading its wings. Indians followed dutifully with no questions asked, the sudden, draconian and unplanned lockdown last March, which led to the exodus of lakhs of migrant workers. Indians even believed the PM when he said that all will be well in 21 days.

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Meanwhile, the states fought their own battles without any tangible help from the Center. Millions were rendered jobless, the poor were left to their helpless fate, the economy tanked and continues to tank, hunger, starvation, anxiety and depression stalked the unhappy landscape, there was ‘no vaccine policy’ worth its name, and people hoped against hope that 2021 will start with a flicker of hope. Remember the PM’s cathartic speech at the World Economic Forum’s Davos Dialogue in January 2021?

“Today, Covid cases are declining rapidly in India… India’s stats cannot be compared with one country as 18 per cent of the world’s population lives here and yet we not only solved our problems but also helped the world fight the pandemic… In these tough times, India has been undertaking its global responsibility from the beginning. When airspace was closed in many countries, India took more than 1 lakh citizens to their countries and delivered essential medicines to more than 150 countries…” 

Significantly, the PM said India’s role will increase with the rollout of more ‘Made in India’ Covid-19 vaccines. Clearly, this was chest-thumping in its most glorious form at the world stage.

Then arrived the deadly second surge, even as the PM and his Union home minster were obsessed with capturing Bengal at any cost, while welcoming millions at the super-spreader Kumbh. The PM was delighted to see huge crowds in one of his last rallies in Bengal. While sections of the stooge media played along, the international media published front page pictures of mass cremations, accompanied with highly critical text putting the entire blame on Modi. And they were on the spot, on the dot. Surely, the mass tragedy was a public spectacle for the world to see!

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Lest we forget, there were tens of thousands dying due to the acute scarcity of hospital beds, oxygen, life-saving drugs, with cremation and burial grounds unable to find space for the dead bodies, while parking lots, pavements, open spaces and public parks in some places were converted into cremation grounds. Some electric crematoriums refused to work because their ‘internal organs’ had melted due to the relentless heat, huge make-shift walls were created to block journalists to report on the relentless mass cremations (in Lucknow), and the data of deaths were allegedly fudged or censored, even while the obituary pages were full of tributes to the dead (as in Gujarat). 

So, is India prepared for the third wave?

On June 19, said Dr Randeep Guleria, Director, All India Institute of Medical Sciences, Delhi:  “We don’t seem to have learnt from what happened between the first and the second wave. Again crowds are building up… people are gathering. It will take some time for the number of cases to start rising at the national level. But it could happen within the next six to eight weeks… maybe a little longer.” He said that unless the population is vaccinated, the country will remain vulnerable in the coming months.

The Hindu reported in early May that that the principal scientific adviser to the government of India has warned that the third wave of Covid-19 is inevitable. “There is, however, no clear time-line on when this third phase will occur. We should be prepared for new waves, and Covid-appropriate behaviour and vaccine upgrades is the way forward,” he said.

Modi has made the promise on live television of total and free vaccination in India after June 21. Hoardings have come up with the PM’s mug shot profusely thanking him for free vaccines. If Rahul Gandhi as much as tweets: ‘July has come. Where are the vaccines?’ some central ministers suddenly emerge from the shadows and Rahul gets a good tongue-lashing.

The situation is as fuzzy as it gets. Noida apparently stopped vaccination from June 30 for a week – reasons not known. Gujarat suspended vaccination recently for unknown reasons – there were no vaccines, according to sources, it was reported. Vaccination was stopped in Mumbai due to lack of vaccines, but restarted again. Almost all the big states reportedly have vaccination shortfalls; Bihar has a shortfall of 71 per cent, while West Bengal, Jharkhand and UP are not far away. Even Kerala and Delhi, who have done the best, will not be able to achieve a 60 per cent target by December.

Is the current scenario optimistic? Not really.

Apparently, about 20 per cent plus have got their first dose, and 5 per cent plus have been fully vaccinated. Surely, at this rate, no one knows when a country of India’s size will ever get ‘fully vaccinated’. And the bitter truth is that less the level of vaccination in the population, the more there are fears of multiple mutations of this killer virus. India, therefore, is as vulnerable as ever.

A Delhi Covid Survivor Shares His Story

By Pankaj Molekhi

While the 2nd wave of Covid-19 is mercifully behind India now, the danse macabre it brought in its wake, during March-May, will continue to haunt many citizens for a lifetime. A first-person account of a Covid survivor in Delhi brings you the situation up close:

The first symptoms showed up benignly: a mild fever of 100 degreeF (38C) and a gentle cough. But I had read enough about Covid to take these signals mildly. I isolated myself from the rest of my family, kept a bottle of sanitizer close and called the local chemist to deliver a pulse Oxy-meter and some medicines.

Warning signs came early. My calls to various pathology test labs for a swab sample to determine the infection were politely turned down. Most labs had suspended their services due to a massive surge. It was after two days that I was able to get myself tested at a hospital unit; the results took another two days.

Meanwhile, I consulted a doctor who specialized in internal medicine and treated Covid patients. I dutifully followed his prescriptions. The brands prescribed were not available at chemist shops but their generic alternatives could be managed. I read every information related to Covid-19 available on the Internet during isolation. I was sure by fifth-sixth day, things will take a positive turn.

But that was not to be.

My fever shot up to 103 degree F on the fifth day. Oxygen level, hitherto 99%, slipped to 95 intermittently. These were not happy signals. I consulted another senior doctor who added a few new medicines, including a cortico-steroid called Medrol. I was told to get back in two days if symptoms did not improve. They did not.

The new doctor advised admission to a hospital. His own facility, he apologized, was packed to capacity. He suggested in case we did not get a hospital bed that day itself, we should take an oxygen concentrator on rent. With my Oxygen levels dwindling, we arranged a concentrator. It was a good decision as by midnight, my O2 score fell off the red-mark 92.

The next day, we began the hunt for a hospital bed afresh. By afternoon, the severity of situation became clear to us. There were no beds available, leave alone a room, in either state or private hospitals across Delhi. Having called at least 50 hospitals and other leads provided by friends, little positive came out. Interestingly, I received a few calls from medical touts who promised a bed with oxygen for Rs 1 Lakh at non-descript facilities. Some offered to set up similar facilities at our place itself with an attendant for a hefty sum. I ignored the medical mafia calls.

I sought help from some of my resourceful friends. One of them posted an SOS on social media site Twitter. This was picked up by common friends and further amplified. By evening, a few windows opened. I was told the Delhi government had set up new Covid facilities and beds were available there. Friends were coordinating with officials to get me admitted there. By then, I was completely dependent on the concentrator for breathing. My family called up an ambulance to take me to any Covid facility that is finalised. My housing society, which had stored oxygen cylinders, offered them during transportation. It looked that things had begun to fall in place.

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Yamuna Sports complex, a large stadium turned into a Covid facility, was finally zeroed in on. I left home with my brother by my side, but as I stepped toward the society elevator, my vision blurred. Suddenly, there was darkness all around. When I opened my eyes again, I was sitting inside an ambulance, with a mask linked to an oxygen cylinder and people looking over me. I had blacked out and was lifted into the vehicle for oxygen feed. I realised the grim situation I was in. At the sports Complex, after some paperwork and running around, I was wheeled in to my assigned bed.

The set-up looked impressive at first sight. The hall was air-conditioned lined with foldable cots as beds, with brand new oxygen concentrators by their side. Young helpful volunteers moved around with tea, eatables and food packets. However, in an hour of my stay, I realized there were no doctors to be seen. “They would come if there is an emergency,” a fellow patient assured me. And then my oxygen concentrator blipped. Having experienced a blackout not long ago, I panicked. None of the uniformed volunteers knew how to fix the machine. Thankfully, a patient detached a tube, filled it with mineral water and re-started it. I knew the set-up was what it had been labeled: temporary.

Yamuna Sports Complex covid centre

The phone signals were weak but I managed to message my family about the ‘Covid camp’ condition. The answer was reassuring: the hunt for a proper hospital was still on. An hour before midnight, I got a call from my wife. She was on her way with an oxygen cylinder to shift me to a hospital in Noida, over 15 km from Delhi border. An editor friend had pulled all stops to get a room with oxygen facility. No ambulance was willing to cross the state border, hence she was coming with my brother.

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The guards and front staff at the hospital told us they were not taking any new patients as there were no beds; even the stretchers had been used as beds in the emergency unit. Another rounds of phone calls and an hour later, I was ushered in. In the few minutes that I took the oxygen mask off, the levels reached dangerously low again. But the expert staff managed the situation in a jiff. For once, since the blackout, I felt safe. I was told by an attendant not to take off the oxygen mask, even while using washroom. I was provided a nasal fork pipe during lunch and dinner.

The travails for the family hadn’t ended yet. They were to arrange Remdesivir injections. Each vial was being sold in black market for Rs 25-50,000 apiece. Then, there were fake injection too in circulation. Somehow these were arranged, two of them from a logistic facility in Manesar, Haryana, some 70 km from the hospital.

Five days, some 150 pills, and two dozen injections later, I was able to walk for a few minutes without the oxygen support. Although steroids fueled my appetite, I lost about 20 pounds. A deep breath took some effort, so did my visit to the attached washroom. I felt tired and my voice came out like a croak. Yes I felt lucky to have just about scraped through.

Upon my discharge after a week’s stay, with much gratitude for friends and family, I felt as if I was stepping into a new world. Travelling home with a precautionary mask on, I rolled down the window. An unseasonal drizzle had brought the temperature down and the fresh air on my face felt good. A song began to play on my lips noiselessly.

PS: During my recovery at home, I kept thinking about thousands of the unlucky ones who could not manage a bed, or arrange the elusive injections; those who stood helplessly to see their dear ones slipping away. It made me choke. I was brought up in New Delhi and was a witness to, as a patient also, its healthcare infrastructure transformed from a few stinky government-run hospitals of the 1970s to private multi-specialty facilities post-1990s. I never believed for a second that an invisible bug could bring this capital infrastructure to its knees in a matter of days. I prayed we had learnt our lessons.

The Pandemic Situation in India

‘India Must Vaccinate Vulnerable Sections On Priority’

By LokMarg

Prof Jimmy Whitworth, a  member of the Scientific Advisory Committee for WHO’s R&D Blueprint for Action to Prevent Epidemics, has been at the helm of several global initiatives on public health research in low- and middle-income countries. An academic staff member at the Liverpool School of Tropical Medicine and the London School of Hygiene & Tropical Medicine, he has rich experience in devising strategy and policy on population health. In an emailed interview, Prof Whitworth spoke with LokMarg about the pandemic situation in India, what to expect in the foreseeable future and how India can tackle the situation.

India has witnessed a deadly second wave of the COVID pandemic that has left in its wake millions of people dying and many more battling with the infection. Although there has been a decline in cases, are there still risks of another wave?

The deadly second wave of COVID-19 in India is now thankfully receding. From a peak of 400,000 new cases a day in early May, there are now around 100,000 new cases per day. However, unless there are concerted efforts to control the epidemic, there are likely to be large waves in the future. These reported numbers of cases are likely to be severe underestimates of the true burden due to a backlog in reporting test results, poor access to testing and many people not being tested because of fear or stigma.

Do you think the Indian government’s decision or recommendation to increase the interval between the first and second doses will have an impact on its efficacy? Or is it, as many believe, an attempt to solve the demand and supply gap for vaccines?

The gap between first and second doses is of minor importance right now, getting vaccines in Indian arms as quickly as possible is the priority. Early on in the pandemic India provided vaccines and medicines for other countries. But now there is a shortage of vaccine supplies in India that is expected to last until July 2021.

The important actions now are to give priority to vaccinations for vulnerable populations, support state level estimates of demand, ensure a coordinated strategy between states and make sure there is an effective supply chain. This means national and state level negotiations are needed to procure vaccines urgently.  There also needs to be a negotiation of patent waivers and clearances for production of a broad set of vaccines with incentives and support for local manufacturers.

One of the variants of the virus in India is believed to be a mutation that is resistant to antidotes. How effective are the vaccines available now? Is there reason to believe that they are not effective against new variants of the COVID virus?

The current vaccines appear to be effective at preventing infection and disease of all of the new variants described so far, although there is some drop-off in effectiveness in protection against some of the strains. The vaccines are still valuable and one of the most important tools that we have to combat this terrible epidemic. Everyone should be encouraged to come forward for vaccination.

How do you think India can best handle the situation there in the context of lack of healthcare infrastructure and the sheer size of the population?

Despite the vast population and fragmented health system, India can control this epidemic. This needs political leadership, with good quality data for decision making. Transparency, public communication and engagement to ensure collective responsibility and action will be important. We need to enhance the ability of health services to respond by expanding the pool of trained, well-protected staff, establish dedicated well-equipped and safe COVID-19 facilities, use primary care for home care, and ensure sufficient medical supplies and oxygen. As well as the need for mass vaccination mentioned above, we need to scale up SARS-CoV-2 testing and expand decentralised contact tracing and isolation. International and domestic travel need to be reduced and made safe through testing and quarantine. Effective bans of gatherings of more than 12 people, closing venues and indoor public spaces and ensuring physical distancing, hand hygiene and mask-wearing will be important to prevent transmission of infection.

What does the future scenario look like? Would most of the world’s population have to live with the reality that the virus and its mutants will continue to be a threat in varying degrees for the foreseeable future?

The measures mentioned above will be sufficient to bring the epidemic under control, however it is likely that this virus will remain in the human population and cause outbreaks for years to come. We will need to adapt to become faster and more effective at controlling these waves of infection. This may need the development of new vaccines to combat variants that occur in the future.

Virus Isn’t Going Away, Prevention Is Our Best Bet

By Dr Arista Lahiri

Coronavirus has turned our lives upside down in more ways than one and even after a year of the pandemic being officially announced, the world is not in the green. As a community medicine practitioner in Epidemiology, I have been studying the behaviour of the novel Coronavirus and its host, us, the humans. Yet, no matter how much I study things in detail, I always come to the same conclusion about the Coronavirus: This virus can change forms (mutate) and come up with new strains faster than we can figure out its cure or vaccine. So, our best bet right now is to avoid the virus! The prevention is easy; the cure may not be.

Our best preventive tools – masks, hand-wash and sanitisers are now easily available. What is not easily available is the will in most people to co-operate and use these tools both for individual safety as well as public health. Even as the number of infected cases and resultant fatalities rise, there is a certain nonchalance in public behaviour regarding the risks. On March 27, more than 62,000 new cases were registered across the country, with over 300 deaths. The first time that the number of people infected in a single day went above 50,000 was July 27, 2020. The last time that the number of new cases went above 50,000 was November 6, 2020.

Even though the number of new infected cases is going up, the ratio of the number of people losing their lives to the infection, is so far less in 2021, than it was in 2020. However, those suffering with manifestations are showing somewhat severe symptoms than before. Though panic is never a way forward, but we should not definitely let our guards down yet as well.

We are seeing a renewed, fresh wave of the virus because the virus has mutated (changed its basic genetic structure and developed newer, more dangerous strains) to survive in its human hosts. We have learnt some strategies to cope with them and the virus too has gained new skills to dodge the human immune system! The influenza virus mutates almost every year and develops new strains. We will have to see which way the wind blows for the novel coronavirus. It definitely has mutated within a year.

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With newer mutations coming up globally we are faced with the threat of the new strains, the UK strain, the South African strain, and the Brazilian strain. It is the antigens that are responsible for stimulating the production of antibodies by the immune system. Even minor mutations depending on the area of the virus they have occurred in, can play in a big way with our immune systems, and are known as ‘variants of concern’. These new variants are identified using a process known as genome sequencing, which reads and then interprets the genetic information found in the RNA- Ribonucleic acid (in this case) of the virus. We need to study the virus to be able to fight it better.

India, through genome sequencing has also detected what is known as a new “double mutant” COVID-19 variant. This means that two important changes are coming together in the same virus. The mutations are basically affecting key areas in the spike protein (the crown-like area which helps the virus to latch on to human cells) of the coronavirus and thus helping them skip or escape the resistance offered by our immune system. This is mostly affecting states like Maharashtra and Delhi the most. Other states closer to these two are also reporting increased number of cases. This is probably because these two states have the maximum international travel (both inward and outward) and thus the maximum exposure to the virus, both by way of the original strain (from Wuhan, China) and the 3 newer strains. At least 18 states and Union Territories in India now have different strains of coronavirus running amok: the UK strain, the South African strain and the Indian strain, so to speak. The threat of infection is high.

What all this means is we are taking one step forward and two steps back in terms of handling the pan-world health crisis. We were all thinking that with the vaccine we would now be saved, but the virus is changing in ways that render the vaccines weak. We cannot say that a person who has been infected once and has received the vaccine as well, won’t be re-infected, though it depends upon an individual’s immune strength as to how his/her body will react and to what level they would be affected.

However, the scientists suggest that the severity of the disease will be bit lesser among the vaccinated individuals – a ray of hope, but still the battle against spread of infection, is on. During the first wave of coronavirus in March 2020 what saved us was the lockdown; it helped in more ways than one to trace and isolate and further treat infected people. However, for all purposes, a second nationwide lockdown doesn’t look feasible, because it affects the people financially when they are not able to earn their livelihood.

What we need right now to handle the second wave is a really strong execution of the plan we already have in place. Public health awareness was already achieved during the first wave; almost the whole population is aware of the crisis as well as the solution, but what is missing is a respect for solutions and the motivation to enact those simple behaviours.

We need strong public health advocacy. Everyday we need to educate, organize and mobilise to change the reluctant and seemingly over-confident attitude among the mass as a whole.  We need people at the grassroots level to reinforce for good the safety measures. So many people have let their guards down after one year of the pandemic. The various state elections, the many political rallies, the many religious festivals (we have the upcoming Kumbh Mela) have all contributed to the pandemic still holding fort really strong. We need strong community level leadership at every possible level. Anyone with a voice that is heard and respected should advocate for the use of masks, regular handwashing and social distancing. I wish some religious leaders across faiths weren’t so dismissive of the severity of the pandemic; since many people listen to them.

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We need to reach out to these leaders so that they can influence their followers. Faith must meet science if we want to overcome the pandemic. Political leaders at centre and state levels need to reach out to every kind of leaders possible, to bring about behaviour changes among the people to eliminate the virus from amidst us. To use a sociological concept, we need to the diffuse ideas of public well-being and precautions so that they become culturally acceptable and thus practiced among large parts of the population. The media plays an important role here.

The onus this second time around is truly on the public. We will keep losing the race to the virus until we follow the basic measures stringently. Lockdowns can only stop inter-cluster exchange or two areas with infection from interacting with each other and thus ceasing a larger spillage, but it may not stop intra-location infections. Nowadays, we have a huge number of people living in societies and apartments. Even if they go out only to buy essential items, but don’t follow basic precautionary measures like masks etc. they can still infect or be infected.

All of us depend on each of us this time. It’s kind of “One for all, all for one” idea! As a Community Medicine expert, I once again want to emphasise that it is the community spirit which will keep us safe and alive. Each one for another! The virus alone is not the real enemy, but our relaxed approach to the virus certainly is! We can weaken it in some time if we strictly follow the rules. The so called herd immunity has not shown promising results in this case, so individual immunity is all we have to turn our communities healthy. If we don’t want another lockdown, let’s bring out masks, sanitisers and the will to keep fighting the contagion – by respecting the social distancing norms. Let us put all efforts to develop a “behavioural herd immunity” this time.

The writer is an epidemiologist at College of Medicine & Sagor Dutta Hospital in Kolkata)

College Of Medicine & Sagor Dutta Hospital in Kolkata

‘In Initial Days Of Covid-19, Doctors Lost Sense Of Time’

By LokMarg

Dr Arista Lahiri, 31, Sr Resident (Epidemiology) at College Of Medicine & Sagor Dutta Hospital in Kolkata, recounts how healthcare professionals battled the unknown virus and why we can’t let the guard down even now

I was fresh out of medical school when the pandemic struck. Even though my field of study was community medicine and thus I was well-versed with the incidence, spread and possible control of diseases during an epidemic/pandemic, yet nothing had prepared us for a crisis of such epic proportions that affected the whole world.

I was posted at the District Hospital in 24 Parganas (North) and had gone to another city to attend a medical conference in January 2020 when coronavirus began to be discussed seriously. Wuhan was already reeling under its impact and slowly the medical fraternity across the world had begun to realise that the virus was soon going to spread much, much farther than China.

In March-end, when the pandemic was officially declared in India, I dedicated myself completely to fighting the unknown virus. We were a four-member team doing 24×7 surveillance of both active as well as potential cases to target and isolate. We were doing everything from data entry to helping Covid patients get admission in hospitals to occasionally going out in the fields to see how the situation was panning out.

ALSO READ: ‘I Delivered My Child Amid Pandemic’

For two-three months we had no sense of time, putting in every hour of work that we could and going home only to sleep. We had no life outside work for those several months and no outlet to unwind. We just kept each other motivated and in good spirits.

Dr Lahiri says battling the virus is not the job of healthcare professionals alone

I was myself scared of the contagion; there were so many people suffering around us. Each day, I pulled myself up and marched on stronger. My parents were extremely supportive and understood my duty as a medical professional.

While the rest of the country was facing only Covid, nature dealt a double blow to West Bengal: cyclone Amphan. I am quite happy with the way our state government handled the crisis. The entire state machinery from the primary to district to state-level worked in tandem. Post-Amphan, there was a shifting of roles and responsibilities and I was asked to be a member of the Covid State Cell in Kolkata in June end.

ALSO READ: ‘Proud To Be A Part Of Vaccination Drive’

We had all learnt better by then and were able to streamline our work better. The workload eased off just a tiny bit, though we were still checking in hundreds and hundreds of patients each day. One thing I was happy about was that I was now living with my parents in Kolkata.

Since then I have been working in Kolkata itself doing 12 hour shifts every day. Between my work as faculty at the College of Medicine and my work at the Sagordutta Hospital, I have to travel nearly 40 kms each day. We cannot afford to slack off even now, though we can relax a bit.

Battling the pandemic isn’t the job of frontline healthcare workers alone. Community medicine is all about a community’s adherence to rules. Even though vaccines have been developed, we need to understand that new strains of the virus might still take over. So masks, sanitizing and social distancing are still our best bets against the virus! I got both my vaccine shots, but I still take all the precautions.

Counsellor at A Community Health Centre in Moradabad

‘Vaccine’s Only Side-Effect Was Mild Fever Overnight’

By LokMarg

Saroj Kumar, 49, a family welfare counsellor and frontline worker amid Covid-19 in Uttar Pradesh, is feeling relieved after receiving the vaccine on the first day of the immunisation drive

I work as family welfare counsellor at a Community Health Centre in Moradabad (Uttar Pradesh) and I can proudly say that healthcare sector workers like us have been the backbone of India’s fight against coronavirus. We faced the virus day in and day out without fear, hours on end.

It was therefore a big relief when the government announced that health professionals and other frontline workers would be vaccinated on priority. As a healthcare professional I was among the people to be vaccinated on January 16, the first day of the immunisation drive.

We had been asked to register ourselves a day prior to the vaccination and post-registration, I was told to reach the designated health centre for the serum shot. I reached the centre at 12:30 pm where my temperature and oxygen levels were checked the first thing at the gate. Next, I was given hand sanitisers and waited for my turn.

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Once I was administered the vaccine jab, which hardly took a minute, I was kept under observation for around half an hour at the centre. Two girls who were making a note of the entry and exit timings of the vaccine beneficiaries, also checked if any of the vaccinated person showed any discomfort or adverse reaction. We had been told that there could be mild side-effects.

Saroj Kumar (wearing a facemask and inset) took a selfie while waiting for the vaccine

My workplace (the very centre I was vaccinated at) is nearly 60 km from home. On the vaccination day, I took the regular bus and faced no discomfort per se on the way. However, I ran mild fever after reaching home around evening. The fever lasted overnight and in the morning my body temperature returned to normal. I am feeling fit as a fiddle now.

During the pandemic when public transport wasn’t available, reaching my workplace was tough. So I had requested to be temporarily allowed to work at a health centre nearer home. The authorities were considerate and I was assigned work at the Chief Medical Office’s office closer home.

My new role was to take calls at the Help Centre. Since it was the beginning of the pandemic, we had to field hundreds of calls each day. So, I can tell you there was much anxiety among people and patients about both the pandemic and its prospective treatment or vaccine.

ALSO READ: A Vaccine Of Hope

Now, I have been working with Covid-positive patients who are isolating at home. Every morning, a doctor, I visit these patients in our district and administer medicine to them as well as monitor their condition. Covid is contagious, but for most people, not deadly. Yet, people are scared as it has caused so many deaths.

I am glad that people like us will now feel completely free and safe after the twin vaccination shots, since we meet many Covid positive patients every day. I am not scared of the virus, but I do have a family of four to take care of. The vaccination process has brought me a lot of mental relief. Given how successful our polio vaccination programme was in the past, across the length and breadth of our country, I am sure we will win the fight against Covid too.

As Told To Yogmaya Singh

‘Proud To Be A Part Of Vaccination Programme’

By LokMarg

Savita Paliwal, 52, a senior vaccinator in Moradabad (UP), is happy to see India among the first few countries to launch vaccination programme early. She explains how the monumental process will unfold

I have been in the medical profession for nearly three decades now and have been involved with quite a few vaccination and immunisation programmes. As a government employee at the Community Health Centre at Thakurdwara, Moradabad, I have been actively involved in building a healthy society. However, this time it is quite different.

Dealing with the Covid-19 is something that we have never seen before in our entire career. Healthcare professionals have been on their toes for nearly a year now. And with new strains coming up at different parts of the world, the challenge is only getting tougher.

It was therefore both a moment of relief and pride when we were informed that India is one of the first few countries to start vaccination programme. We have compiled the beneficiary list in our zone and have had two dry runs, on January 5 and 8.

We have been divided into two teams of three members each. Both teams have one vaccinator, one helper and a data expert (someone who keeps track of the beneficiaries who get vaccination). Healthcare professionals, especially the pharmacists and paramedical staff will be given the vaccine on priority basis.

ALSO READ: A Vaccine Of Hope

The phase 1 of the programme begins on January 16. Each team is supposed to vaccinate 25 people in a day, so in our locality you can say that the Community Health Centre employees will be vaccinating around 50 people daily. The process will be spread across five rooms with standard operating procedure in place like regular sanitization, temperature screening etc.

Savita Paliwal (middle) with her colleagues at Moradabad community health centre

The DM (district magistrate) was very involved in how the dry runs were conducted and there was total cooperation from the Chief Minster’s office as well. I feel happy that we are all functioning as one smooth machinery.

Of course, many people are scared of taking vaccines but as someone with an extensive experience in this field I know how to soothe people. Asha workers are also involved in the vaccination programme, and spreading awareness about it.

Moradabad was declared a hotspot last year and I would say we expect most people to be co-operative. No query of the beneficiaries will be considered insignificant and we will take care to also inform them of the minor side-effects they might encounter after the vaccination.

ALSO READ: Nursing Our Healthcare System

I feel lucky to be a part of this monumental process. I have been keeping myself updated with all the news about vaccines developed in India as well as other countries and I would say so far we have handled the Covid-19 situation really well. But it is not over yet and the pandemic needs the cooperation of every single citizen of the country. I make it a point to carry extra masks in my bag and hand them free to anyone I see not wearing a mask.

I feel proud that India developed and mass-produce a vaccine in good time and now we aren’t dependent on any foreign country for the immunity programme. I wonder how the scientists who developed the vaccines must have raced against time to save as many lives as possible. I hope the process goes smoothly. We have managed and eradicated polio and now we are confident we shall put corona virus behind us too.