Another surge of Covid-19 in India

Dr Dharmakanta Kumbhakar

(The writer can be reached at drkdharmakanta@yahoo.com)

India had been enjoying the endemic state of Covid-19 for almost four and half months, from the mid of July to the end of November 2021. Life started to become normal in the country. Offices, educational institutions, markets were open. People expected that no third wave of Covid-19 will come to India. But the scenery began to change at the end of December and everything appeared to point towards yet another surge of Covid-19 in India, leading to a possible third wave of the disease. Covid-19 positive cases began to shoot up. There was an almost threefold rise of Covid-19 positive cases in the last week of December (18,290 new cases between December 26, 2021, and January 2, 2022) compared to the third week of December (6,641 new cases between December 19 and 25) in India. Today, rising numbers of Covid-19 positive cases more than 1.5 lakh per day across the country are an indicator that India is already in the early throes of a third wave. This wave is predominantly driven by a new variant of the SARS Cov-2 virus, named by the World Health Organization as Omicron.

On November 26, 2021, the World Health Organization designated the variant B.1.1.529 of the SARS Cov-2 virus, named Omicron, as a variant of concern. According to WHO's Covid-19 technical expert, scientific studies have revealed that the mutations have allowed the Omicron variant to adhere to human cells more easily. Early data accessed from South Africa, the US, the UK and Europe which has so far been highly impacted by the Omicron variant indicates that it is more transmissible (more easily spread from person to person) compared to other variants of SARS Cov-2 virus, including the so-far dominant Delta variant. Fortunately, the Omicron variant appears to be less virulent than the Delta variant. It causes milder disease. The replication of the Omicron variant has been observed in the upper respiratory tract- which is different from Delta and other variants- including the ancestral strain which replicated in the lower respiratory tract and the lungs. Data also suggest that the Omicron variant can evade defence mechanisms erected by prior SARS Cov-2 virus infection or vaccination.

Experience in other countries for the Omicron variant clearly shows that India must expect a huge rise in Omicron infections in the third wave. Considering the prevalent data about Omicron variant infections in other countries, the disease might become more widespread in India during the third wave and daily cases far higher compared to previous waves making more people susceptible to infection. However, the newer variant being milder may lead to fewer hospitalizations and lesser mortality in India as compared to the Delta drove the second wave. But, at the same time due to the higher transmission rate of the new variant, the sheer volume of cases could lead to a significant number of deaths and pressurize the health system of the country. Moreover, as the Omicron variant can even infect individuals who have already had Covid-19 or are being double or triple vaccinated, it can create a scenario in India which prevailed at the start of the pandemic in 2020, when everyone was vulnerable to infection. The positive expect is that the data yielded so far from the Omicron impacted regions show that the surge caused by the new variant doesn't last long. One can expect that India will also not face a prolonged third wave. However, considering the unpredicted nature of the SARS Cov-2 virus, it is not possible to comment and predict the severity of the Omicron variant, duration of the third wave and its impact in India. Hence, the best defence against Omicron infection in our country is to rigorously observe the Covid-19 protocols and the administration's guidance.

With the third wave of Covid-19, this time in its new avatar as Omicron, already hitting all the states of India; the government, health agencies and the citizens have a bigger role to play in containment and checking the spread of the virus. India has the experience of devastation seen with the first and second waves of the evolving pandemic situation. Hence the Government and health agencies have already begun preparations to tackle the third wave. The administration has cautiously started to impose restrictions. The Central Government has already imposed restrictions on international flights. Though it is uncertain whether the current Covid-19 vaccination can provide immunity against the Omicron variant, the second dose Covid-19 vaccination and booster third dose of vaccine to health workers, frontline workers and citizens above 60 years with medical problems (minimum of a nine-month gap between the second and third dose) at an early date will be able to reduce the severity and morbidity of disease from the new variant. The Government should reduce the gap to science-based six months between the second and third dose to increase the number of the third dose vaccinated people. Vaccination of the 15-18 years age group will assist in widening the immunization range also.

The citizens of India must behave responsibly for checking the spread of the virus. The rapid spread of Omicron in India is because of a combination of factors including increased social mixing. Death is a tragic phenomenon not dependant on the numbers and that of even one individual is a cause of grief. Thus the realization must seep into citizens that, by behaving irresponsibly, they might be abetting the demise of someone who might not be related to them, breaking up families and bringing about immense grief. Therefore, the citizens of India need to think about reducing their exposure to the virus and taking control of its transmission. They must strictly follow the Covid-19 protocols prescribed by health experts; unfortunately, most of the citizens seem to have forgotten. The use of well-fitting masks and hand sanitisers, frequent hand washing, maintaining respiratory hygiene, avoiding poorly ventilated or crowded places and maintaining physical distancing should be followed strictly. The Government and the authorities can only appeal to the people to wear a mask and wash their hands frequently. But it cannot go from door to door to wrap a mask on the face of every person or wash their hands. It is to be noted that about 80 per cent of Omicron cases are asymptomatic, meaning that overt indications are not detectable, and in the absence of well-fitted masks, an infected person can move around in crowds spreading the disease. Moreover, as younger people are less likely to be symptomatic of the Omicron variant, they may be a constant source of infections to the vulnerable groups, the elderly or individuals with comorbidities, pregnant women and children. Therefore, wearing a well-fitted mask must be strictly ensured by the citizens. People can avoid others who don't wear masks properly. Not buying things from the shopkeepers who don't wear masks properly and refusing entry of people without masks in establishments as well as homes can also protect a sizable section of people in the society from Covid-19 infection. People must get vaccinated when it's their turn.