The Covid Scare: The Nightmare Is Back!

We thought we had defeated the monster, but it is back, and it is more ferocious than ever before. The virus has mutated and that is causing massive destruction of both lives and resources in fighting it. Recent reports suggest that a third mutation in the B.1.617 (the variant of SARS-CoV-2 found in India) has been identified and is a cause of great alarm. It is believed that this strain is more infectious but data on just how virulent it is, is still being gathered.

Yes, the government has allowed vaccination for all above the ages of 18 from 1 May, but the situation remains grim. As we compile this report, news comes in of oxygen tank leaks and the death of 22 patients at a Nashik hospital - this when the country is witnessing a shortage of beds and oxygen tanks in hospitals. In his address to the nation in mid-April Prime Minister Narendra Modi urged Indians to follow Covid appropriate behaviour and directed states to use the lockdown as a last resort. Of course, after the economic dent the last lockdown had caused – the administration is understandably cautious.

Mend the Healthcare Infrastructure However, opinion is divided on this – take for instance the case of Uttar Pradesh. The Allahabad High Court ordered five districts in Uttar Pradesh to opt for a lockdown but the state government moved the Supreme Court and got the order repealed, citing administrative and economic difficulties.

Yes, lockdowns do cause a disruption to livelihoods, but we are not succeeding in being able to manage the spread of this deadly disease. Should we not therefore, prioritise human lives first? With more reports coming in of young people passing away from the virus – one is tempted to ask whether what we are doing to curb the outbreak is enough.

We must start by increasing the spend on healthcare, which at this point is less than two per cent of the country’s GDP. The government plans to increase this expenditure to 2.5 per cent by 2025 but this has to be done sooner. The healthcare infrastructure needs an overhaul, medical education requires inclusion of the latest technology and doctors and nurses need to be compensated fairly.

Every tragedy offers a lesson and a chance to be prepared for a similar eventuality in the future. The goal should be to recover from this crisis and build a robust healthcare system that can bear the strain of any future eventuality.

‘PEAK MAY COME IN MID-MAY’ In an exclusive conversation with BW Businessworld Dr. Rommel Tickoo, Director - Internal Medicine, Max Hospital, Saket, shares his views on the causes that culd have contributed to the sudden leap in Covid-19 cases. He also talks about the challenges the healthcare sector faces in managing the pandemic and the precautions required to be taken and gives us a glimpse of the post-pandemic world as we learn to live with the virus. Excerpts:

What are the causes of the secondwave of Covid-19? 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 less 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. A Critical Situation What are the challenges in management that the healthcare sector faces at the moment? There has been an exponential increase in the numbers (of active cases) 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. Peak in Mid-May What is the outlook? Do you think we will be in a better place two months from now? The way in which the numbers have gone up, the peak might come midMay or in the latter part of May, but then the numbers will dip. The 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 third and a fourth 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 the vaccine will also come much later. We are vaccinating now but the benefits will show up six months down the line Need for Booster Shots Will people who have already got the two doses of vaccine require another shot or a booster? 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. Efficacy Tell us about the efficacy of the vaccine in regard to the new strains that are coming up? None of the vaccines are 100 per cent efficacious. The ones that we are giving are 70 to 80 per cent 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. Herd Immunity How long will it take us to achieve herd immunity? 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 centres are being added, we also need more vaccines (some of which have been approved abroad). Precautions What can we do in the meantime, till all of us get vaccinated? 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 the 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.