By Artika Bansal
New Delhi: India is currently witnessing a surge in COVID-19 infections across states. This has led to speculation that it could be the onset of the fourth wave in the country.
India’s daily COVID-19 tally has crossed the 10,000-mark for the first time since February. According to the Union Health Ministry, India logged 12,781 new COVID-19 cases as of Monday and the country’s active caseload has now increased to 76,700.
Amidst the scare of the fourth wave in the country, 22 out of 36 states and union territories have seen an increase in COVID-19 infections. The question of whether India should be worried about the upsurge is inevitable.
Surge in daily infections
Speaking to ETHealthWorld, Dr Anantha Krishnan C, Consultant, Internal Medicine and Infectious Diseases, Prashanth Hospitals, Chennai, “We are passing from a pandemic stage to an endemic stage where COVID-19 will become one among the viral flus and there will be multiple spikes localised everywhere depending on the subset and the age of virus present.”
While few have developed a very callous and indifferent attitude towards covid-appropriate behaviour, there is also a group of people who fear infection due to the deaths and severity of the earlier waves in 2020 and 2021.
Dr GC Khilnani, Chairman, Institute of Pulmonary, Critical Care & Sleep Medicine, PSRI, said, “What we are seeing now are variants of Omicron, which includes BA.1, BA.2, BA.4 and BA.5. The US cases are that of BA.2.12.1 which is 25 times more contagious. As of now, there are no reports of this new variant in India.” Dr Khilnani also shared that with the ease of restrictions in travelling and other physical activities, there has been an increase in the spread of COVID-19 and Omicron variants among vulnerable individuals.
Similarities between COVID-19 infection, seasonal infections
With the change in weather, COVID-19, the common cold, seasonal allergies and the flu have shown similar signs and symptoms. Commenting on the same, Dr Krishnan C said, “The current variant is almost close to the common flu. So the symptoms which we witness are also very mild in terms of infections, like fever and throat pain etc with no pulmonary involvement, or hospitalisations. In the current scenario, only after accurate tests can one determine and differentiate between the common flu and COVID-19.” Adding to this, Dr Khilnani said diarrhoea might also be a symptom to test for COVID-19 in these new variant infections, but certainly not pneumonia.
Monitoring the situation closely
The Government of India (GoI) is closely monitoring the situation and taking appropriate action to prevent the situation from spiralling out of control where there is a shortage of medical supplies as well as medical facilities to take care of those who are infected by the virus. Keeping in mind the havoc caused by the earlier coronavirus waves, the authorities have been preparing the hospitals and healthcare centres with all the possible equipment and facilities that might be required.
Dr Monica Mahajan, Director, Internal Medicine, Max Healthcare, Delhi, said, “The past few weeks have seen an increasing number of COVID-19 cases being reported in India. This data only represents the tip of the iceberg as the number of people self-testing themselves for COVID-19 at home is huge and that pool of patients does not even get reported. The current viruses are of the Omicron lineage. They are more transmissible or infectious but perhaps less severe than the ‘previously circulating variants of concern’ like the delta that killed millions of people across the globe. The future can hold the development of either stronger or milder disease-causing variants. The potential for the resurgence of some of the previous variants can also be a possibility. Hence, a close eye needs to be kept on the disease variants and we cannot let our guard down.”
Vaccinating the eligible
The Union Health Minister recently chaired a meeting to assess the situation and advised on tracking and tracing, following COVID-19 appropriate behaviour, also reinforced the COVID-19 vaccination drive through the HarGharDastak 2.0 campaign and making sure that there is no wastage of vaccines. Doctors have thoroughly emphasised the importance of getting vaccinated, not just first and second dose, but also in the precaution dose.
With the advent of technology, not just information but misinformation also spread fast. Recently, myths related to taking the precautionary dose were all over digital media. Dr Mahajan highlighted vaccines and said, “Those who have been fully vaccinated have the advantage of getting a milder disease. Most cases of mortality at the moment are those who did not receive the vaccine or had multiple co-morbidities. There is a drop in the number of patients needing hospitalisation which is a relief for the overburdened healthcare facilities during the delta wave. Vaccines save lives irrespective of whichever COVID-19 vaccine is being taken.”
Commenting on the myth that the first two doses are enough against the covid virus, Dr Krishnan C said “Since things are transitioning back to normal, stressing on the importance of precautionary doses has been forgotten. This should not be the case as acceptability must only improve and people must realise that these precautionary doses are as important as the first two doses. More reinforcement sessions must happen from the central government side or the health sector to ensure people take this up seriously.”
Studies conducted by the Indian Council of Medical Research (ICMR) have suggested that the antibody level declines after around six months of the primary vaccination with both doses and giving a booster only increases the immune response. Dr Khilani added to this and said, “To pick up the immunity and reduce the chances of getting infected by viruses, periodical vaccination is needed for the body’s immune system.” It is safe to say, the strongest instrument to control the surge and reduce mortalities, is vaccination against the virus.
Dr Pruthu Narendra Dhekane, Consultant Infectious Diseases, Fortis Hospital, Bengaluru, shared reasons for the low acceptability of the precaution dose and its contribution to the spike in coronavirus infections. According to him, “Precaution dose acceptance has become low because ‘out of sight out of mind’ has been the tendency of most people. Despite the decline in cases in the last three-four months, doctors and govt have been encouraging people to finish their course of vaccines and follow social precautions. But all of this has gone for a toss, hardly anyone is wearing a mask or wearing it properly, people for whatever reason aren’t finishing the vaccination course and no one is ready to test even if symptomatic. All these factors have contributed if not being the sole or major responsible factor for the increase in cases.”
Precaution necessary to prevent the fourth wave
The more the sub-variant of coronavirus and Omicron, the more we think about precautions. Doctors suggest similar precautions as known before. Wear a mask, especially in crowded areas, practice social distancing, regular hand wash and if you come in contact with someone already infected, isolate immediately and get tested. Dr P Kuganantham, Senior Consultant and HOD, Social Medicine, SIMS Hospital, Chennai, said “Though severity is less, the major precautions to be taken along with those known, are that we need to be very cautious with people having chronic ailments like cancer, asthma, diabetes and hypertension. We need to ensure people take up vaccinations and eat food rich in vitamins, minerals and immunity-boosting. One should continue with regular washing of mouth and hands as well as masking and maintaining social distancing even if one is vaccinated. Focus more on the basics and keep a proper check on the symptoms.”
There is no official deadline for the coronavirus or the Omicron or any variant of the two. Taking necessary precautions and keeping a close eye on the variants and symptoms is thus important. Vaccination acts as a barrier against the virus and will be extremely helpful in controlling the surge which if not controlled can lead to another serious COVID-19 wave, the fourth wave in India.