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'Second and third waves will be more intense'

By SHOBHA WARRIER
April 16, 2021 08:12 IST
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'If we again become complacent at the end of the second wave, we are going to suffer more as it will be even more intense.'

IMAGE: An isolation ward for COVID-19 patients at the Shehnai banquet hall in New Delhi, which has been converted into a temporary COVID-19 facility, April 14, 2021. Photograph: ANI Photo
 

Early 2021, Indians were breathing easy and many felt the novel coronavirus that was wreaking havoc all over the world, has disappeared from India.

Then came April and the virus is back with a vengeance.

It is not back to 2020 again; 2021 appears to be worse than 2020.

The question that the virus fatigued people are asking is, when is this going to end? Wish anyone could answer this question.

Dr Shekhar Mande, Director-General, Council of Scientific and Industrial Research, tells Shobha Warrier/Rediff.com how we can fight the virus and subjugate it.

IMAGE: Deserted streets in Mumbai, April 11, 2021. Photograph: ANI Photo

With covid cases increasing exponentially, people are talking about an impending lockdown. Do you think a lockdown is the answer to controlling the virus?

There are pros and cons to it. Lockdown is to isolate people, like you saw last year when we had a national lockdown. But it had a very dire consequence on the economy.

So, a society must take a considered call and decide what is more important. We have seen all over the world that every country is trying to strike a balance between fighting the virus and saving the economy.

So, there will be some restrictions on people's movements and even local lockdowns where there are more cases instead of the entire city.

IMAGE: Passengers arriving from Maharashtra at the Prayagraj railway station, April 14, 2021. Photograph: PTI Photo

Last year, the national lockdown destroyed the entire economy, killed small businesses and hundreds and thousands of people lost their jobs. Can India afford another lockdown even if it is localised?

Any lockdown will have some consequence on the economy. For example, if a city like Mumbai had a lockdown, it would have a huge impact on the economy of the entire nation.

Depending upon where the cases are, a full lockdown of the nation or a state may not be necessary. What we could have may be local and restricted lockdowns.

Even when there is a lockdown, the virus is not going to anywhere. So, through lockdowns, are we not just delaying the infections?

The idea is to break the chain of transmission as much as possible. The chain of transmission is through respiratory droplets from person to person.

Then, if we can bring it under control at a particular stage, you can lift the lockdown.

Wherever there are Covid cases, you should immediately do testing and contact tracing and isolate all the positive people. This method had been successful in the past. In fact, many diseases were eventually eliminated too this way.

What is needed is a combined strategy of vaccination and breaking the chain of infections.

IMAGE: A crowded vegetable market in Moradabad, April 14, 2021. Photograph: ANI Photo

What is the rationale behind the night lockdowns?

What we have found out is that the virus spreads mainly through respiratory droplets. They tend to remain suspended in the air in closed rooms and in rooms where there is no proper ventilation.

Also, if there are more people in a closed room, the probability of some of them having a virus in them is quite high.

In the open areas, respiratory droplets do not remain suspended for long. They get dissipated very fast.

This has led to the understanding that this virus spreads more effectively in closed, less ventilated areas than in open space.

After the covid cases went down dramatically in December and January, we have realised that people started socialising a lot, having birthday parties and wedding parties, and these parties happen in closed areas.

So, because of the negative impact on the economy, we have to continue with the economic activities during the day but put a curb on socialising after work, at night like going to the pubs, restaurants, having parties etc.

That's why we are in a situation where we need evening lockdowns to control the spread of the virus.

IMAGE: A policeman asks people to wear face masks in the New Market area of Kolkata, April 14, 2021. Photograph: Swapan Mahapatra/PTI Photo

In the second wave, we see that the virus is spreading faster and cases are doubling in a much short period compared to the first wave. Is it because the virus has become more virulent due to mutations?

The first principle to understand is that the second and the third waves are more intense than the first wave. Even the Spanish flu of 1919 also had multiple waves, and each new wave became more and more intense before it ended eventually and became an endemic.

There are multiple reasons behind the pandemics coming in waves. One of the reasons is that once a wave dies down, people tend to drop guard. They become complacent and start normal activities as if the pandemic did not exist without realising that the chain of the transmission had not been broken completely.

Next reason is, people start socialising.

The third reason of course is the mutants. Of course, studies are going on to find out whether the UK mutant B.1.1.7 is spreading faster or not. We should know the results in the next two weeks. Then, we will be able to say whether mutants are also contributing to the spread.

So, it is due to the combination of all these factors is that we have a rise in the number of covid cases.

IMAGE: Patients wear oxygen masks as they wait inside ambulances to enter a COVID-19 hospital in Ahmedabad, April 14, 2021. Photograph: Amit Dave/Reuters

But the mortality rate in the second wave is low. Is it because the vulnerable got infected earlier and many people in the vulnerable group are also vaccinated now?

Yes, a large section of the people who are susceptible, those above the age of 65, those with co-morbidities, succumbed to the disease in the first wave, unfortunately.

So, the percentage of the vulnerable has reduced considerably. And many of them are vaccinated now too.

All these put together, the fatality rate has come down.

IMAGE: A woman receives a dose of the Covishield vaccine in Prayagraj, April 14, 2021. Photograph: ANI Photo

It is said that youngsters who are testing positive now are asymptomatic and without any serious problems. Is it a good way to attain herd immunity?

Herd immunity is too dangerous an idea to even think about. You get herd immunity when the virus infects 70%-80% of the population. By the time herd immunity happens, it will be catastrophic. We don't want to move towards to that.

When the virus infects more number of people, the more it mutates. Therefore, we should not even think about herd immunity.

The only way to break the chain is vaccination which we have to do as fast as we can, and adhering to covid appropriate behaviour like wearing masks and maintaining social distancing.

People should not think that after vaccination, they are completely protected as vaccine efficiency is 70%-80%-90% and not 100%. So, despite vaccination, there are people who still remain susceptible. Those who are vaccinated also may get infected, but with less intensity.

So, it is very, very important that even after vaccination, people must continue with covid appropriate behaviour.

IMAGE: A healthcare worker carries oxygen cylinders at a COVID-19 hospital in Ahmedabad, April 14, 2021. Photograph: Amit Dave/Reuters

Last year the UN Nobel agency said 2021 would be worse than 2020. But people expected the virus to go away by 2021. It turned out the Nobel agency is right in its prediction...

All pandemics come in waves and the second and third waves will be more intense. Let's hope that the second wave ends soon. Eventually when the second wave subsides, there is a possibility of a third wave.

If we again become complacent at the end of the second wave, we are going to suffer more as it will be even more intense.

So, it is very important for all of us to remember that all pandemics come in waves and despite vaccination, people must continue with covid appropriate behaviour.

IMAGE: Dr Shekhar Mande.

You said, if a third wave comes, it will be more intense. By more intense, do you mean it will spread faster or the mortality rate will be high?

Mortality rate will steadily drop beyond a particular point.

How long do you think it will take for the virus to take a pause?

Mutations will never stop; it is a natural process. Nobody can stop mutations in the genetic make-up; it will keep happening.

What will happen over a period of time is, viruses will become less and less lethal and eventually it will become an endemic.

It could take a few years, perhaps.

Feature Presentation: Ashish Narsale/ Rediff.com

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The War Against Coronavirus

The War Against Coronavirus