Bracing for the third Covid-19 wave

The World Health Organization (WHO) chief Tedros Adhanom Ghebreyesus recently warned nations about the early stages of the third wave of Covid-19 amid the surge and spread of the delta variants. As the virus is continuously mutating into more transmissible variants such as the delta variant which has become the predominat variant, the third wave is already hitting several European and Southeast Asian countries, with rising cases and increasing deaths, and seems imminent in India.

Based on different mathematical models, the current predictions by various Indian researchers and leading medical bodies, indicate that a third wave can be expected to strike India in the months of September-October, 2021.

According to a serosurvey conducted by ICMR in June and July 2021 across 70 districts of 21 states has found SARS-CoV-2 antibodies in two-third of Indians above the age of 6, thereby suggesting that 40 crore people or one-third of the country’s population is still vulnerable to the novel coronavirus.

Drawing from the learnings of the first two waves, leading health experts have suggested several measures to counter the third wave, these include:

Sustained surveillance, and sharing of data to guide future interventions

Systematic testing, collection, compilation, and analysis of clinical, epidemiological, and laboratory data hold the key to decision making. In this context, as indicated by the WHO chief scientist Dr Sowmya Swaminathan, India needs to strengthen its surveillance and closely monitor key Covid-19 indicators to reduce the impact of a possible third wave. Stringent genomic surveillance and monitoring of viral epidemiology and genetic diversity can help explain the evolving nature of the pandemic and help the authorities in making more informed decisions.

Robust healthcare infra

While the second wave has made the medical fraternity more experienced at patient management, with the clearcut guidelines in management, there is still a critical need to scale up infrastructure. Maintainence of Covid Care Centers, with beds, ICU units, oxygen supply, and availability of medications including the key medications is a pivotal step. The use of technology for teleconsultation, forecasting trends and managing procurement and supply chains for delivering essential drugs and vaccines has already been initiated and must continue. In addition, training healthcare professionals for better management of patients across the disease spectrum could reduce the load on the hospitals. The use of digital platforms for training could help a large number of workers gain the requisite skills in a short time.

Vaccinations

Vaccination provide significant protection against severe disease and hospitalisations. Breakthrough infections can occur but are likely to be mild in most instances. New data emerging on vaccines suggest that vaccination against Covid-19 provides three times stronger immune response than when recovering from an infection,and this response is seven times higher in the younger age group. Indeed, a third wave could be significantly blunted or delayed, by scaling up the vaccination drive. Alternate strategies to protect the vulnerable population are being considered. For example, the CDC in the US is considering whether fully vaccinated people with weakened immune systems need a booster dose of the covid vaccine.

Covid-appropriate behaviour must continue

Continuing with covid appropriate behaviour, mandatory use of masks, social distancing, restrictions on mass gatherings, localised mini-lockdowns, and micro containments, must be implemented which can keep the number of cases under control, despite large scale restrictions being lifted in most states.

Three key factors can determine the next wave— the nature of the virus, the extent of vaccination and people’s behaviour. Armed with the knowledge of our past, we can with confidence chart a course for our future. Without a doubt, a vigilant and better prepared India can tide over an incoming third wave. With all the stakeholders coming together, the battle against the virus can be won, slowly but surely. It is but a matter of time.

(The writer is Global Chief Medical Officer at a pharmaceutical company)