Health & Wellness

Covid 19 Pandemic

Before we could get some breathing space from the 2nd Wave of Covid 19 Pandemic, 3rd Wave by Delta Plus Strain of the Virus is almost banging at the door. This time the crisis is going to leave most of us just a whisker away from death. It is Human Survival Vs Complete Crash

The scenario can be worse than a Nuclear War, where people perish in a moment! In contrast, a staggering death toll in a Pandemic of this magnitude can quickly cascade into a Chain Reaction which will be a devastation, more for the survivors than the dead.

This projection is not to generate fear psychosis amongst people. Rather it is mandatory that everyone is aware of the reality. Whatever happens next, will be the common fate of entire population, irrespective of Religion, Caste or Status. Urban or Rural, Wealthy or Poor, all will suffer equally. The Virus will not differentiate between anyone.

For Doctors it will be a nightmare, much beyond the physically and emotionally draining 2nd Wave.

The 2nd Wave - Fact Check

According to latest scientific data, Covid-19 being a novel pandemic, its patterns of growth and spread are still emerging. Inspite of the tragic storm of 2nd wave in India, the death rate from Covid-19 is very similar across countries, with India still among the lowest.

But this is no reason to be complacent. In order to handle the 3rd Wave with more deliberation, we must objectively review our short falls during the onslaught of 2nd Wave.

Covid appropriate behavior by the public was a must, but was by and large flouted.

The casual approach was reflected at social as well as political levels.  Mass accumulation of people should have been avoided and reverse migration should have been checked, at any cost. This lack of foresight and quick response took the Virus from Urban to Rural location.  As an aftermath of sudden spurt of serious cases resulting from mass gatherings under various pretexts, the constrained Medical Infrastructure came to an irreversible strangulation point.

The 3rd Wave Challenge

Like most Respiratory Viral infections, we don't have a specific antiviral for Covid 19. Most of these Viral infections like Common Cold are self-limiting and do not become life threatening.

The Covid 19 Virus is New, Unnatural and Highly Contagious.  Though it's Mortality is only around 1-2%, but world has never been exposed to it. The Natural Human Immunity against it is ZERO. The infection erupted like a volcano and swept across all nations before any steps could be taken.

The onset of Pandemic was so catastrophic that in the 1st Wave, Doctors in sheer desperation could not do anything else but to try whatever best options were already available. It was found that the virus preferentially attacked the lungs and arterial walls. A Protocol was prepared to support the Respiratory System, till the patient managed to fight it out by developing necessary antibodies.

Our Vaccine Arsenal

Doctors knew that there had to be another way out. Scientific experience knew that Vaccination builds up Immunity against the Virus. Indian Virologists succeeded in establishing Viral Genome decoding. Once the surface characteristics of the Virus that penetrated normal human defense system were identified, scientists did a mammoth job in developing an indigenous vaccine. But trials for success and safety are time consuming. Bulk production for a new vaccine is a challenge. The good point was that support from various administrative and political sections came remarkably fast.

India is a hugely populated country. Making Vaccine reach from production to its recipient needs high efficiency and zeal at all levels. We are still in an elementary phase of vaccination. It is not possible to vaccinate everyone overnight.

A ' Threshold ' mass of population needs to be vaccinated at the earliest possible to develop sufficient Immunity and dilute the 3rd Wave. The only way to let that happen is to delay the onset of the 3rd Wave for as long as we can . It is like just holding back the enemy till reinforcement comes.

Natural Herd Immunity Vs Vaccination

Herd Immunity is an elusive concept. Most Doctors all over the world are against letting people get exposed to Covid 19 and develop Natural Immunity. It is a High-Risk process.

Herd Immunity would be able to make the Pandemic go into regression only if 85%-90% population gets vaccinated. Till then our life cannot return to normal.

In entire US where Vaccination is going full steam, only 40% population is fully Vaccinated right now. Though Covid is not a Public Health Hazard anymore, but Herd Immunity is nowhere in sight.

In comparison fully vaccinated population of India stands at 3.5%!

This means that we are not only far from herd immunity, we are highly susceptible to succumb to the 3rd Wave, because the Delta Plus strain is a mutated and more virulent strain.

Most countries have seen multiples waves, some even 3 or 4 waves, so we have no reason to believe that we will be unaffected.

What we need to ensure is that we have battle-ready work force that can mount its response whenever, wherever there is an emerging wave.

The basic strategy to manage Pandemic resurgence includes-

Ø     •  Surveillance

•  Testing

•  Tracking

Even a small error in judgement and lack of brisk reaction can make things go out of hand.

In the meantime, Vaccination is our only weapon in this war against Covid. There are a lot of queries and confusion in public minds regarding types of Vaccines.

All vaccines try to achieve the same thing – develop immunity to the virus, and some might also be able to stop transmission. They do so by stimulating an immune response to an antigen, a molecule found on the virus surface.

Strategy for rolling out vaccine drives:

India needs to Vaccinate a minimum of 9 million people per day at the earliest to keep the 3rd Wave from creating a Holocaust.

When enough people (threshold population) have immunity against Covid, either due to infection or vaccination, it would significantly reduce the rate of spread and contain transmission within smaller pockets of location and restrict the Pandemic.

Will the 3rd Wave give us time to get prepared?

Let us look at the facts as they are.

There is no rocket science in delaying the 3rd Wave.

Stay Away From The Virus

1. Wear the mask properly.

2. Maintain Social Distancing.

3. Avoid mass gatherings, crowded places, undue exposure at public places.

4. Personal hygiene.  Frequent use of soap and water to wash hands. Use sanitizers after any contact.

What goes wrong if we do not follow Covid appropriate behavior?

We give the virus an upper hand. As society opens up more broadly, the virus mutates to become more contagious.  Infection rates shoot up again and virus becomes more virulent.

Since we are not currently at a level of protection that can allow life to return to normal without seeing another spike in cases and deaths, it is now a race between Infection and Vaccination.

The Catch:

No doubt, man is a social animal and goes into depression if there is a prolonged deprivation of social contact. Pandemic Fatigue makes people get emotionally exhausted and stressed.

But let’s not forget the stress our Doctors are undergoing while managing the unimaginable workload, grief and suffering all around them, 24 hours a day, bound in a PPE kit, with no time to even ease themselves for prolonged hours. How much exhausted they must be at this moment and the 3rd Wave is here, almost.

There is a general sense of pseudo jubilation with the ebbing of the 2nd Wave. People are suddenly feeling relieved and are breaking free from the rigorous psychological constraints of Lockdown. In the process they are exposing themselves to the Delta Plus Strain too early.

There is no shortcut to escape this Delta Positive strain.  The mortality to virus is around 1 -2%, but the transmission is just too high.

Now the worst part -

For un-immunized population with co morbidities such as diabetes, asthma, or hypertension, getting a COVID infection would be lethal.

Children for whom Vaccine is still in a trial phase, are going to be hit the worst. Our Pediatric and Neonatal Intensive Care especially in villages is grossly inadequate.

Please keep your children at home and Virus away from your home.

What lies ahead?

The human population is so interconnected, an outbreak anywhere can lead to a resurgence everywhere.

 This is a global concern as well. As long as there are unvaccinated populations in the world, SARS-

CoV-2 will continue to spread and mutate, and additional variants will emerge.

The Virus has not gone anywhere and we only have a strained Health Care System to depend upon. There is no new medically significant breakthrough. The basic Medical Protocol of Supportive Care is same as before.  Soon demand will be skyrocketing and we should better beware of our limits. We have seen it all in 2nd Wave.

The Bottom Line:

In India the 3rd Wave will be a catastrophe if we let it strike us . When Covid becomes aggressive, all available Medical Care resources are sucked into  its management.  So the mortality from Non Covid causes also rises.

Public and Covid Task Force, both have to be on high alert 24/7. It is unpredictable which pocket will become the trigger point.

We have to collectively do our best to slow the disease transmission around our micro environment, until the threshold population is vaccinated.

By: Dr Neelam Verma

MBBS; MD | Consultant Physician- Cardiologist |Vedic Gram (A Wellness Farm)

Photo Credit: Safety photo created by freepik - www.freepik.com