The World Health Organisation recently warned nations about the early stages of the third wave of Covid-19 amid the surge and spread of the delta variants. As the virus is continuously mutating into more transmissible variants, the third wave is already hitting several European and Southeast Asian countries, and seems imminent in India.
Based on different mathematical models, the current predictions by various Indian researchers and leading medical bodies indicate that a third wave can be expected to strike India in September-October 2021.
According to a sero survey conducted by the Indian Council of Medical Research (ICMR) in June and July across 70 districts of 21 States, SARS-CoV-2 antibodies have been found in two-thirds of Indians above the age of six, thereby suggesting that 40 crore people or one-third of the country’s population is still vulnerable to the novel coronavirus.
Drawing from the learnings of the first two waves, health experts have suggested several measures to counter the third wave, these include:
Sustained surveillance , and sharing of data to guide future interventions: Systematic testing, collection, compilation, and analysis of clinical, epidemiological, and laboratory data hold the key to decision-making.
In this context, as indicated by the WHO Chief Scientist, Sowmya Swaminathan, India needs to strengthen its surveillance and closely monitor key Covid indicators to reduce the impact of a possible third wave. Stringent genomic surveillance and monitoring of viral epidemiology and genetic diversity can help explain the evolving nature of the pandemic and help the authorities in making more informed decisions.
Overall, this will enable us to design more effective healthcare strategies to better protect those at greater risk and also formulate region-specific strategies to curb the spread and severity of the virus.
Robust healthcare infrastructure: While the second wave has made the medical fraternity more experienced at patient management, there is still a critical need to scale up infrastructure. Maintenance of Covid care centres, with beds, ICU units, oxygen supply, and availability of medications including the key medications is a pivotal step. The use of technology for tele-consultation, forecasting trends, and managing procurement and supply chains for delivering essential drugs and vaccines has already been initiated and must continue. In addition, training healthcare professionals for better management of patients across the disease spectrum could reduce the load on the hospitals.
Focus on post-Covid care rehabilitation: Many patients who have recovered from an active Covid infection are experiencing long-term residual effects of the disease both physically and mentally. The current setup does not offer any specific guidance to these individuals. There is a dire need to establish post-Covid care clinics and services to address these requirements comprehensively.
Focus on the susceptible population, including children: The susceptible population including children need to be protected. Many countries, including India, now have a clear-cut protocol for Covid management in children.
Continue to bring in new treatments: Globally, researchers are working to create new prophylactic and therapeutic interventions to combat Covid. Among the newer treatments available in India monoclonal antibodies have high efficacy in mitigating the progression of the disease, reduce the risk of hospitalisation or death by 70 per cent in international studies and thereby potentially reduce the overall burden on the healthcare system.
Vaccination — the key driver in the fight against Covid: Vaccination provides significant protection against severe diseases and hospitalisations. Breakthrough infections can occur but are likely to be mild in most instances. New data emerging on vaccines suggest that vaccination against Covid provides three times stronger immune response than when recovering from an infection, and this response is seven times higher in the younger age group.
Indeed, a third wave could be significantly blunted or delayed, by scaling up the vaccination drive. Alternative strategies to protect the vulnerable population are being considered. For example, the Centers for Disease Control (CDC) in the US is considering whether fully vaccinated people with weakened immune systems need a booster dose of the Covid vaccine.
Covid appropriate behaviour must continue: Continuing with Covid appropriate behaviour, mandatory use of masks, social distancing, restrictions on mass gatherings, localised mini lockdowns, and micro containments, must be implemented which can keep the number of cases under control, despite large-scale restrictions being lifted in most States.
Three key factors can determine the next wave — the nature of the virus, the extent of vaccination and people’s behaviour. Armed with the knowledge of our past, we can with confidence chart a course for our future. Without a doubt, a vigilant and better prepared India can tide over an incoming third wave. With all the stakeholders coming together, the battle against the virus can be won, slowly but surely. It is but a matter of time.
The writer is Global Chief Medical Officer, Cipla