A Critical Situation

With 2 million active Covid-19 cases, the second wave of coronavirus is creating havoc in the country. Even though the government has allowed vaccine for all above the age of 18 from May 1, the situation remains grim because of the massive strain on health infrastructure.  

In an exclusive conversation Dr. Rommel Tickoo, Associate Director - Internal Medicine, Max Hospital, Saket speaks about the reasons contributing to the increase in Covid-19 cases, the challenges in management and the outlook.  

JS: What are some of the causes, challenges in management and the outlook of the second wave of Covid-19?  
RT: The causes are various mutant strains in India. Apart from that, it has a lot to do with the attitude of people – nobody is following the norms. Till sometime back the curbs were lesser and people thought that the virus is dead and gone. There were gatherings taking place, and people were not wearing masks or maintaining social distancing - this has a lot to do with the spike in the numbers. The virus is such that it evolves over a period of time, we did well in the first phase but right now it has hit us hard. There has been an exponential increase in the numbers which is very difficult to cope with, but the government is ramping up the infrastructure. There will be shortages of beds because the numbers have increased overnight, but I am sure, we will be able to handle it the way we have done earlier.   

JS: What is the outlook, do you think we will be in a better place two months from now?
RT: The way that the numbers have gone up, the peak might come mid-May or in the latter part of May, but then the numbers will dip. Majority of people will get infected and over a period of time the numbers will definitely go down.  

India being a huge country there might also be a 3rd and a 4th wave till we reach some sort of immunity or ramp up vaccination - we have to be prepared. Another key factor to keep in mind is that the benefits of vaccine will also come much later, we are vaccinating now but the benefits will show up six months down the line.    

JS: Will people who have already got the 2 doses of vaccine require another shot or a booster?  
RT: I think so. Pfizer and Moderna are thinking about giving a booster dose to people who have had their two doses, and the same would go for all others as well. With the kind of mutant strains prevalent right now the vaccines might need to be tweaked a little bit. Covid-19 is here to stay, and I think every year we might need a booster shot.   

JS: Tell us about vaccine efficacy in regard to the new strains that are coming up? 
RT: None of the vaccines are 100 per cent efficacious. The ones that we are giving are 70 to 80 percent efficacious, which is good enough because even if you get Covid-19 after the jabs, you will not end up in the hospital and the seriousness of the disease will be low.  

JS: How long will it take us to achieve herd immunity?  
RT: It will definitely take us more than six months. Maybe even up to the second half of next year because India is a large country, and it is a humongous task to vaccinate each and every individual.  

The vaccination drive is being ramped up, more centers are being added, we also need more vaccines (some of which have been approved abroad).  

JS: What is that we can do in the meantime, till all of us get vaccinated?  
RT: Do not step out of the house unless it is required or there is an emergency. Work from home as much as possible. If you have to step out, then wear the mask which tightly fits on your face. The best mask is one that gives you discomfort, it has to tightly fit on your face covering your nose, chin, cheeks and there should be no gap. Double masks are required where social distancing is not possible at crowded places, healthcare institutes, malls, pharmacies etc.