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The second wave is all set to hit India-how scared should we be?

  • HEALTH
  • Team PresentMirror | Updated: March 27, 2021, 7:52 a.m.




While the western world already saw an unabated rise in COVID-19 cases last winter, India seems to have arrived in the red zone now. In its highest daily spike of 2021, India reported 46,951 fresh Covid-19 cases in a single day pushing the overall tally to 11,646,081. Experts are already of the opinion that there's no reason we should not expect a second wave following the trajectory of infections in other countries.


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The COVID-19 cases have been rising at an alarming rate prompting states like Punjab, Maharashtra, Madhya Pradesh and Karnataka to impose strict COVID-19 measures. Lockdowns, night curfews have been imposed in many districts and cities to stop the spread of the infection.

Countries that are three to four months ahead of India in terms of the pandemic have seen their second wave, Dr V Subramanian, infectious diseases specialist at Apollo Hospital said at a panel discussion on the novel coronavirus. The second wave will come to India too, but will be milder and hopefully will fizzle out faster than the first, Subramanian added.

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Latest data from the Present Mirror COVID-19 tracker

Will the second wave be more deadly?

The last few days have been concerning owing to the sudden surge in COVID-19 infections and the possible return of another national level lockdown. Meanwhile, the Directorate General of Civil Aviation (DGCA) has already extended the suspension of international commercial flights till April 30. Delhi and Mumbai have banned public celebrations for upcoming festivals such as Holi and Navratri as well as gathering in general, amid a spike in COVID-19 cases. While the government has taken necessary steps to combat the scourging spread of infection, the one thing that experts are finding more dreadful is the more virulent strains of viruses emerging from the U.K.,Brazil and South Africa.

One of the participatory appraisals from the University of Oxford, has shared his concern over the more novel strains of coronaviruses and their deadlier effects on vaccine and immunity. 'Government of India, in its written answer in the Lok Sabha (19 March), admitted that out of 19,092 samples that were sent for sequencing of viral genome, INSACOG has been able to sequence only 4869 samples.'

'Among the 4869 sequenced viral genomes, 11 samples are positive for the deadly Brazilian variant (which is estimated to be about 3 times more virulent), 11 samples are positive for the South African strain and 284 for the British variant. One shouldn’t be surprised if there are some indigenous strains of coronavirus that are circulating in the country.

If this is the result from just the 4869 samples sequenced, then Brazil and SA variants have now spread much widely and we are simply clueless about the spread. The UK, on the other hand, has conducted a sequencing of about 250,000 samples and alerted the world about various variants of concerns.

Another huge problem that is being reported with some new variants is that they are not only evading the vaccines (people who have received 2 doses of vaccines have been found covid19 positive in some countries). There are hints that these variants might also be evading the RT-PCR tests which obviously need more detailed studies to prove their grounds.

However, the rate at which Covid19 is spreading in India - especially Maharashtra - both the government and public need to exercise utmost caution.', he added.

Among the 4869 sequenced viral genomes, 11 samples are positive for the deadly Brazilian variant (which is estimated to be about 3 times more virulent), 11 samples are positive for the South African strain and 284 for the British variant. I won't be surprised if there are some indigenous strains of coronavirus that are circulating in the country. If this is the result from just the 4869 samples sequenced, I am confident that the Brazil and SA variants have now spread much widely and we are simply clueless about the spread. The UK, on the other hand, conducted a sequencing of about 250,000 samples and alerted the world about various variants of concerns.

Lately, a top US health official warned that the spread of highly contagious variants was threatening to fuel a "potential third surge of cases" in various countries. The Brazil variant appears more contagious and may evade immunity provided by past infection, scientists say. The British variant has already been found responsible for a chunk of new infections in the US and Europe.

Genome scientists, in order to beef up what was a limited surveillance system to track the genetic histories of local samples of the Sars-CoV-2 virus, that causes Covid-19 are "investigating" two variants found in samples in states like Maharashtra and Telangana which have seen a surge in infection rates. "We are collecting more samples from the field to investigate whether the two variants have any link with the surge. We cannot be complacent," Dr Sujeet Kumar Singh, director of India's National Centre for Disease Control, said.

Government has upped the ante for increased protection against Covid-19 infections. The Ministry of Home Affairs (MHA) has released a fresh set of guidelines for the month of April, asking states to enhance the proportion of RT-PCR tests, strictly enforce the 'test-track-treat' protocol and speed up the pace of Covid-19 vaccination to cover all priority groups. We are not certain that the second wave will not be as deadly as the first one although the vigilant administration and the prudent and timely decisions on part of the government may just bring home an extra goal.

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Image file : A snap from the GOI press meet on COVID-19, Credits: PIB

An indigenous 'double mutant' variant giving us an angry stare

While India's efforts to ensure rapid testing and smooth rollout of Covid-19 vaccination, including the development of several digital platforms like CoWIN and Aarogya Setu is indeed laudable, the emergence of a 'Variant of Concern' has got scientists and doctors in a sweat.

Genome sequencing and analysis have been carried out on samples from arriving international travelers, contacts of those positive for VOC and community samples from most of the states at INSACOG (Indian SARS-CoV-2 Genomics Consortium) partner laboratories, which are 10 in number. "The analysis of samples from Maharashtra has revealed that compared to December 2020, there has been an increase in the fraction of samples with the E484Q and L452R mutations. Such mutations confer immune escape and increased infectivity. These mutations have been found in about 15-20% of samples and do not match any previously catalogued VOCs. These have been categorized as VOCs but require the same epidemiological and public health response of “increased testing, comprehensive tracking of close contacts, prompt isolation of positive cases & contacts as well as treatment as per National Treatment Protocol” by the States/UTs," the ministry said.

Immune escape occurs when the immune system of a human being ("host") is unable to respond to an infectious agent, or in other words, the host's immune system is no longer able to recognize and eliminate a virus or pathogen.

From Kerala 2032 samples (from all 14 districts) have been sequenced. The N440K variant that is associated with immune escape has been found in 123 samples from 11 districts. This variant was earlier found in 33% of samples from Andhra Pradesh, and in 53 of 104 samples from Telangana. This variant has also been reported from 16 other countries including the UK, Denmark, Singapore, Japan and Australia.

"Though VOCs and a new double mutant variant have been found in India, these have not been detected in numbers sufficient to either establish or direct relationship or explain the rapid increase in cases in some states. Genomic sequencing and epidemiological studies are continuing to further analyze the situation," the ministry further added.

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Image Credits: cnbc

The director-general of the World Health Organization, Tedros Adhanom Ghebreyesus said that the recent increase in coronavirus cases and deaths represent truly worrying trends and they could take us back to square one if not stopped in time. As long as we continue providing the logistics and the accommodation for the virus to circulate, people will keep dying, trade will get disrupted and the economic recovery will be further delayed.

This article uses inputs and research by Adrija Ray Chaudhury and Dr. Kshitij Mohan Singh

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