Let’s be realistic with Covid-19
A combination approach is required to tap the increasing cases of Covid across nation.
Whenever there is a pandemic hit, the history has explained that there is no single approach that becomes successful to tide over it. There is no second thought that SARS-CoV2 is going to have an exponential growth in terms of transmission until we come up with joint efforts using a combination of multiple approaches. While comparing the situations of 2020 and 2021, the fear among the people has shown a dip. Masks which were one of the important wearable last year, are rarely seen on the faces, these days. A strict lockdown must compromise to pacify many socio-economic challenges. No doubt the recovered people with immunity have increased in numbers, but increasing deaths and hospital care, still remains a challenge.
While talking about the wave, its not studied in the locality or the city, but however smaller waves make the addition to the broader wave in the country. Change is the law of nature and unluckily the virus is following it to the best. The mutated virus is successful to escape the immune pressure and the declined zeal of precautions. These both serves as a fuel for the pandemic explosions.
As per the CSIR, mutations of the virus make it able to evade what little immunity remains. The INSACOG sequencing consortium data clearly shows that not only have we seen explosive growth of imported variants, such as the B.1.1.7 UK variant, in Punjab, but have also had emergence of local variants such as B.1.617 in Maharashtra. The latter, with 15 lineage defining mutations, and two immune escape mutations — E484Q and L452R amino acid changes in the spike protein at sites important for antibody neutralization and virus entry into cell — is worrisome. At a molecular level, these mutations make the virus more transmissible and able to evade immunity, potentially causing larger outbreaks and reinfections. Unlike B.1.1.7, where there is adequate vaccine data from UK to be confident that vaccination will prevent severe disease, we are yet to fully learn about the properties of B.1.617.
So, taking all the above discussion in the considerations there are multiple factors on which the Government should work on to keep a tap on Covid waves. The multiple factors are:
· More comprehensive sequencing- As the second wave has made a worse hit globally, the mutants, majorly seen in south Africa, UK, Brazil, and India has made the situation critical. The speed of the mutation is far more than the evolution of vaccine. The new mutant usually nullifies the pharmacological effect of the developed vaccine. As we cannot beg more time, the faster and comprehensive gene sequencing is the need of an hour. The officials should redirect a robust funds to the biotechnological sector to keep a tap on the mutants.
· Viral Research- ICMR led institute like National institute of virology, should work on the molecular-genetic analysis and cultural research, new and re-emerging viral infections, effect of epidemic on developed and developing countries, faster and effective diagnostic techniques, modeling of human tissues with in vivo-like architectures and physiologies to study viral infection, propagation, evolution, patient-to-patient transmission and host responses in vitro; specially in context of Covid-19.
· Enhanced clinical correlation- Whether its clinical trails or the data from the treating intensivists, the clinical correlation needs to be established with a well-defined trend. A generalized information on the adverse events of the vaccination without any risk management plans cannot lay a foundation for future. DCGI and ICMR should work closely on this. The newsletter should include the updates on the mutant strains, safety data of vaccines and other important medical information related to the infections. The virologists and epidemiologists should have a right to provide their independent opinions.
· Public action: Although there are many challenges to implement the instructions and usually it takes time, but there is not clock start even for the war. The readiness should be in place. The gap between the realization of the loss and its curative action is so huge that the irreparable effect which cannot be undone. Few of the quick robust actions are:
o Timely sealing of international borders (the delay may have caused the entry of UK strain in India).
o Political and religious proceedings- Don’t they need a tap?
o A uniform lockdown irrespective of the states- The borders are static not the people.
o Medical response to the pandemics and effective trainings including the vaccination.
o Forecast of the pandemic waves and their effects.
The bottom line is instead of being wishful about the future, we should shape it. Vaccine alone is not going to make us win. It is a high time, and it will be a shear failure, if we cannot identify the measures at this point of time. The combinations need an execution at a same instance for the cumulative action.