By Nishindra Kinjalk
As the lockdown curbs are lifted, India seems to be heading towards next wave of Covid 19. Whether the next wave shall be as catastrophic or not, remains to be seen. The concern about severe infections among children is sure, worrisome.
The Indian healthcare system had almost collapsed in the months of April and May this year, during the second wave of Covid 19. It was found to bedue to delta variant of SARS CoV2 virus.
There is acute shortage of vaccine for the masses above 18, and no vaccine permitted for under 18. The situation in the coming weeks could be really challenging, if yet a new variant of corona virus choses to strike.And it seems to have arrived in a new incarnation of delta plus.
K Vijay Raghavan,senior scientific advisor to the Government of India had stated earlier this month, that the third wave of Covid was inevitable. It augurs well here to appreciate that a significant surge in the cases of certain diseases over a sustained period, is termed ‘a wave’.
“The third wave is certainly a possibility due to the repeated social laxity in ignoring Covid appropriate precautions, both by the government and by the general public”, says senior virologist in Delhi, Col (Dr) Partha Roy.
Delta variant has been labelled as the “variant of concern’ (VOC) by the USA top agency Centre for Diseases Control (CDC).
This variant that had a devastating effect in India took huge toll of human lives. An official data states the deaths due to Covid -19 to be 3.85 lakhs, with 2.98 crores of the Covid -19 cases. However, unofficial sources claim the toll to be anywhere seven to ten times the official figure.
The virus is continuously mutating, so whichever variant circulates at a given point of time, causes the surge in cases. The magnitude of infection and its severity shall depend on the infectivity and the virulence of virus; and on the way host responds. The host response can very well be manipulated by herd immunity and the vaccination.
Dr Roy cautions that it is high time, the healthcare providers and the policymakers rose to this challenge, and ensured that vaccine is freely available to all. It is also important to see that vaccination covers at least 70 percent of our population at risk, and that too within a defined timeframe. If feasible, it should be achieved by the end of September 2021.
These new microbes — earlier HIV, then MERS Co-V2, Nipah viruses and the mutated strains of old known viruses — owe their reincarnation to the state of gross interference with the balance in our ecosystem.
Deforestation, global warming, atomic radiation, the uninhibited preponderance of electromagnetic waves all over; these sure have changed the ways of nature.
New microbes find it uncomfortable in usual habitat, and drift out looking for zones of less discomfort. And the human beings are found off guard. Low immune status due to various reasons, including lifestyle diseases, longevity etc., adds to the dismay.
The traditional ways of living have a lot to offer, for the benefit of mankind. Clean air, clean water, organic fresh vegetables and locally grown fruits are the best way to boost the immunity.
One does not need to spend a fortune buying the magic immune boosting pills. Such pills and patio are now mushrooming around in ads and online sales market.
Asokan Cheriyandyil, former Additional General Manager with NTPC, an environmentalist and director of Innovative Indian Ideas Consultancy, adds that the villages in India are self-sufficient to take care of their needs.
All India needed urgently, was to prioritize its concerns and focus on the majority of its population that lives in rural sector.
New Delhi must ensure the quality healthcare, education and legal services at the district headquarters. The nation can’t simply thrive on bare slogans. The quality of essential services so ensured, that no one is forced to migrate from the native land and add to the beeline towards a big city.
Emphasizing the need for holistic approach towards healthcare needs, Asokan says that instead of looking down upon Ayurveda and other non-allopathic systems of medicine, their potential benefits must be explored. Quality research and training in these fields can help us develop a cost-effective approach to healthy living.
He laments that urban India has totally forgotten the rich Indian heritage of music, art and culture. Indian traditional music has the ingredients of music therapy. Music therapy can add as an important tool in handling the psychological issues related to Covid -19.
Variants of political concern?
There is a surge of Covid in UK, with the delta variant. With USA reporting 10 percent of its cases to be due to delta variant, there is a strong reason to believe that delta variant may be clubbed as a Variant of High Consequence (VOHC).
And in the name of containing the infection and to control the spread of the pandemic, if it happens to be so, the political boundaries shall become less defined and the interference from big powers likely to cross the limits of convenience of sovereign nations.
Three classes of SARS-CoV2 variants are there, as per the Centers for Disease Control and Prevention in USA.
- Variant of Interest (VOI)
- Variant of Concern (VOC)
- Variant of High Consequence (VOHC)
The variant that caused so much damage in India, Delta (B.1.617.2), was earlier a VOI, and now it has been put in VOC, along with Alpha(B.1.1.7), Beta (B.1.351), Gamma (P.1)and Epsilon (B.1.427 & B.1.429).
Expensive cocktail of monoclonal antibodies (MAB). Will it work against delta plus?
There is a report coming that new mutation in Delta virus has led to a new variant called delta plus, due to K417 mutation. This variant called ‘AY.1’ appears to have made it possible for it to evade action from the cocktail of monoclonal antibodies (MAB),casirivimab and imdevimab.
Its use was authorized by the Central Drugs Standard Control Organisation(CDSCO). It was launchedin India in the second half of May by Cipla and Rosche, making headlines as a magic pill; single dose for an individual costing approximately Rs sixty thousand, that too available at select centers in big cities.
With new delta plus spreading wings, will this expensive option serve a purpose? Purpose of the pharma industry, or the masses? It is time to wait and watch.
*The writer is Consultant in Internal Medicine