We are living in a Covid-continuous world. Post festive season has once again seen the rise of Covid-19 cases. However, the silver lining (and everyone is looking for one) is that so far there has not been the mad rush for hospitalisation with most of the cases, barring a few isolated ones, being managed at home through consultations. In fact on 16th November, India had logged 8,865 fresh coronavirus cases, which is the lowest rise in cases in a day over the last nine months. The country also reported 197 deaths. As reported by a news website “The country’s active cases account for less than 1 per cent of total cases and it is currently at 0.38 per cent, the lowest since March 2020. The recovery rate is currently at 98.27 per cent, which is the highest since the beginning of the pandemic.”
This is good news. But it comes with a note of caution, to remember what happened during the dreaded second wave. It began with the statistics which claimed that so many unknown citizens were infected with the coronavirus. Then these statistics became anecdotal evidence as someone on our WhatsApp groups claimed to know someone who had been infected. And then suddenly we knew someone who had been infected. And the virus came home. So, one should treat the rising statistics with gloves (and masks) as the first sign of trouble. Europe and parts of Central Asia are already recording an alarming rise in the cases. According to WHO one of the reasons for this is insufficient vaccination coverage and relaxation of social distancing and masking. Both these conditions also apply to India where we have seen a surge of crowds during the festive season, and this trend threatens to continue well into next month when we take into account the number of weddings that have been planned for November-December.
As far as the pace of vaccination is concerned, India has completed 300 days of its mega vaccination drive. With as many as 111 crore doses being given, as many as 80 percent of its population has taken the first dose but not even 40 percent of the population is fully vaccinated. During the second wave, we had a shortage of vaccinations, post that there was a rush to the vaccination centres in July-August-September, but with the second wave ebbing, so did the enthusiasm. Now we are told that private hospitals that had procured the stocks have a pile of unused vaccinations that come with an expiration date. With the rush ebbing at the free vaccination centres most prefer to head there then chalk out anything from Rs 780 to Rs 1400 for their shots. The cost is significant when you take three to four family members into account, so most prefer the public sector which offers it free of charge. As Dr Harsh Mahajan, Founder Mahajan Imaging commented on the News-Sunday Guardian Roundtable , “We need to bring in the private sector to have last mile connectivity. The vaccination drive needs to pick up from 50 to 60 lakhs a day to one crore a day. There are lakhs of doses lying with private hospitals which could be nearing their expiry decision, A decision needs to be taken soon so that nothing goes to waste for these vaccinations are worth more than gold.” While the PM has asked state governments to look into starting a door to door campaign but these are decisions that need to be taken fast.
As Dr Rommel Tickoo, Director, Internal Medicine, Max Healthcare, said on Roundtable, “For the last 3 months we hardly had any cases but for the last 2 weeks have cases coming in not for hospitalisation but for consultations. Cases have started coming in and the experts had warned that post festive seasons we will see gatherings and cases rising. All the 7 to 8 patients under me have been vaccinated fully and some have mild to moderate pneumonia also. So, to think that just because we are vaccinated we won’t get it is wrong. It won’t be as serious and need hospitalisation.” He added, “We have done very well with the vaccination program but the second jab is overdue for 12 crore people. We need to give it to them and to those who have not taken a single dose. Three months back we had 40,000 cases a day but in the last two weeks it’s less than 15000 cases a day and before that it was about 20,000 cases a month.”
There is also some good news on preventive medicines and oral vaccinations on the anvil but these will take time. And currently we are also facing a rise in cases of dengue, with over 1200 a week since November. A virulent dengue can cause multi-organ failure and currently these are the cases that are occupying our hospital beds. The rise in dengue, and even some cases of the Zika virus with the rise in pollution and the onset of winter should put us all on alert for the last thing we need right now is another spike in Covid cases.
One has to also be careful about the threat from abroad. With the opening of borders and tourists coming in one does not know which way the virus will mutate. Hence one has to keep that mask on and ensure that everyone takes their vaccinations. The government is also reportedly considering a booster dose, for the elderly and those with comorbidities and also for the Health Care workers who took their second dose as far back as February-March last year. Dr Mahajan adds, “Zika is still in localised areas and hasn’t led to severe cases, but we definitely don’t need another wave or a new strain of Covid. It is the masks that prevent and save us from new and old strains. Unfortunately masks are back to the Febuary level when we had thought we had overcome the virus but we should remember the masks protect us from both the virus and the pollution.”
And don’t forget the round of elections that are coming up early next year. So one really needs to keep the mask on and not be caught off guard as we did last year when we declared a premature victory.