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Don’t let your guard down, Covid can return: AIIMS Director

Dr Randeep Guleria, Director, All India Institutes of Medical Sciences, Delhi, says there has been no community spread in India yet, but corona cases can spike if precautionary guidelines are not followed.

Do you think infection rate has come down in Delhi?

 A. Infection rate is coming down in Delhi and in few other cities as well. It’s possibly increasing in smaller cities as in few cities like in Patna and Guwahati, cases are increasing. So, there are different areas where cases are peaking and flattening at different times. I think certain larger cities have started peaking and flattening but smaller cities are now showing an increase in cases and will peak in a few days.

Q. Serological survey shows infection rate is high in Delhi. What does it mean?

A. It shows there are certain numbers of people who have mild symptoms or are asymptomatic but they had Covid-19 infection. It means that a significant number of people have mild infection as compared to serious infection. We have to continue the protective measures like social distancing, masks, testing, tracking and isolating. If we will not follow such precautionary measures then again people have to face a spike.

Q. Do you think if migrants will return then the cases will rise again? As you said earlier that case would spike again in the month of September?

A. We have to be very careful how to manage when people return back to Delhi or other cities. Monitoring people closely in case of infection and they have to be properly isolated as well. If we are not careful, then there will be a rise in cases.

Q. What is herd immunity? How does it work? Do you think India can get herd-immunity?

A. In case of herd immunity, it has to be 60 percent of positive cases then only it works. We have just 23 percent positive cases, meaning it is going to be difficult to achieve herd immunity; another way to get herd immunity is vaccination. It will help people become immune because this will break the chain and will reduce the number of cases. This virus takes time to make antibodies. In most countries, infection rate is less and for herd immunity infection rate should be high.

Q. Have you seen the mutation of this virus? If there is mutation then it’s going to make the virus more virulent, or does it make it more infectious in increasing cases?

A. A lot of research is going on virus mutation. If it happens then there will always be a mild mutation but till now, we don’t have much data that the virus has changed so much that it’s spreading very rapidly as compared to the past or causing more deaths. Some people have a hypothetical reason that there is less mortality in India or Asia because the virus may have mutated when it came to this part of the world, causing less mortality, but there is now scientific data to support this.

Q. Do you think there is community spread in India?

A. According to the sero survey, there is no community spread. Earlier Bengaluru was doing very well but people started going to the bars, gatherings and the virus again came back. Even now in Delhi cases are coming down significantly. Earlier there were 4,000 cases in a single day but it’s decreased. But on the other hand, the sero survey says that 77 percent of the population is still susceptible therefore you can’t let your guard down and you have to be cautious in terms of social distancing, mask wearing. In Karnataka, they opened up too quickly which led to an increase in the number of cases. It’s also happened in some states of the US.

Q. Do you think Covid-19 can become worse if pollution level is high?

A. There is no conclusive study. I don’t think it’s true. During lockdown pollution came down significantly, but viruses didn’t come down.

 Q. What do you think about school opening for children?

A. It depends on the situation in that particular city. We have to be very careful because if children go to the schools, they won’t be able to maintain social distancing. There may be a certain spread in the school but they might not know that. Children can get the infection and they can take it to their grandparents who can get a very serious infection and that can also lead to a higher chance of death.

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