The unanswered question of the day, “How a life form invisible to human eye has kept the world on toes for two years and how it may ‘end?’
“Man selects only for his own good: Nature only for that of the being which she tends.” Charles Darwin
The COVID-19 pandemic, also known as the coronavirus pandemic, is an ongoing global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The novel virus was first identified from an outbreak in the Chinese city of Wuhan in December 2019, and attempts to contain it there failed, allowing it to spread across the globe. The World Health Organization (WHO) declared a Public Health Emergency of International Concern on 30 January 2020 and a pandemic on 11 March 2020. As of 8 January 2022, the pandemic had caused more than 303 million cases and 5.48 million deaths, making it one of the deadliest in history.
COVID-19 symptoms range from undetectable to deadly. Severe illness is more likely in elderly patients and those with certain underlying medical conditions. COVID 19 transmits when people breathe in air contaminated by droplets and small airborne particles containing the virus. The risk of breathing these in is highest when people are in close proximity, but they can be inhaled over longer distances, particularly indoors. Transmission can also occur if contaminated fluids reach the eyes, nose or mouth, and, rarely, via contaminated surfaces. Infected persons are typically contagious for 10 days, and can spread the virus even if they do not develop symptoms. Mutations have produced many strains (variants) with varying degrees of infectivity and virulence.
The pandemic triggered severe social and economic disruption around the world, including the largest global recession since the Great Depression. Widespread supply shortages, including food shortages, were caused by supply chain disruption and panic buying. The resultant near-global lockdowns saw an unprecedented pollution decrease. Educational institutions and public areas were partially or fully closed in many jurisdictions, and many events were cancelled or postponed. Misinformation circulated through social media and mass media, and political tensions intensified. The pandemic raised issues of racial and geographic discrimination, health equity, and the balance between public health imperatives and individual rights.
COVID-19 vaccines have been approved and widely distributed in various countries since December 2020. Other recommended preventive measures include social distancing, masking, improving ventilation and air filtration, and quarantining those who have been exposed or are symptomatic. Treatments include monoclonal antibodies and symptom control. Governmental interventions include travel restrictions, lockdowns, business restrictions and closures, workplace hazard controls, quarantines, testing systems, and tracing contacts of the infected.
The data we currently have available show us that COVID-19 vaccines are still very effective at preventing serious illness and death against all of the current variants of concern. It is important to note that the vaccines provide different levels of protection from infection, mild disease, severe disease, hospitalization and death.
No vaccine is 100% effective. Even though COVID-19 vaccines are highly effective at protecting you against serious illness and death, some people will still get ill from COVID-19 after vaccination. You could also pass the virus on to others who are not vaccinated. This makes it very important to continue to practice protective measures, even after you have been fully vaccinated.
It is more important than ever to get vaccinated as soon as it is your turn and continue to practice protective measures after vaccination.
Covid-19 Pandemic in India
The first case in India was reported on 30 January 2020. India ordered a nationwide lockdown starting 24 March 2020, with a phased unlock beginning 1 June 2020. Six cities accounted for around half of reported cases—Mumbai, Delhi, Ahmedabad, Chennai, Pune and Kolkata.
A second wave hit India in April 2021, straining healthcare services. On 21 October 2021 it was reported that the country had surpassed 1 billion vaccinations.
Several variants have been named by WHO and labelled as a variant of concern (VoC) or a variant of interest (VoI). They share the more infectious D614G mutation:Delta dominated and then eliminated earlier VoC from most jurisdictions. Omicron’s immune escape ability may allow it to spread via breakthrough infections, which in turn may allow it to coexist with Delta, which more often infects the unvaccinated.
What is the Delta variant?
The Delta variant is a variant of concern classified by WHO on May 11, 2021 and is currently the dominant variant that is circulating globally. Delta spreads more easily than earlier strains of the virus and is responsible for more cases and deaths worldwide. All approved COVID-19 vaccines currently in use are safe and effective in preventing severe disease and death against the Delta variant.
What is the Omicron variant?
The Omicron variant, variant B.1.1.529, was first reported to WHO on 24 November 2021 and was classified as a variant of concern by WHO on 26 November 2021. The classification was made on the advice of the Technical Advisory Group on Virus Evolution, based primarily on information from South Africa that the variant has a large number of mutations and has caused a detrimental change in COVID-19 epidemiology.
What makes the Omicron variant different from other variants?
All variants are different. The Omicron variant has a large number of mutations which may mean the virus acts differently from other variants that are circulating.
Hope against a hope
National health experts feel that though Covid-19 case may peak in India soon, the current wave driven by the omicron variant of the virus may equally fast.
“Global data and our own experience during the past five weeks reveal that that the infection caused by Omicron is mostly either asymptomatic or mild. Few seriously ill hospitalised patients either had other co-morbidities or are over 60 years of age. The overall hospitalisation rate for people affected by omicron is 1-2%, which is much less to the rate of people requiring care in hospital during the Covid wave caused by the Delta,” Dr N K Arora, chairman of the Covid-19 working group of immunisations, told media on Saturday.
“Over 80% of the people in the country have been naturally infected by the virus. Over 91% adults have received at least one dose of anti-Covid vaccine, while more than 66% people aged above 18 years have received both the doses of the vaccine. Keeping all this in mind, the overall impact of current surge in Covid cases is likely to be much less. There is no need to panic. But we should remain vigilant and follow the Covid protocols,” he said.
With the country reporting 1.41 lakh new Covid infections in the past 24 hours and active cases hovering around 4.8 lakh, the expert said the massive surge in the cases was indicative of the third wave. “But just like the increase in cases, a fall can also be expected in the areas reporting cases driven by Omicron,” Dr Arora said.
More than 50% of the Omicron cases are being reported from major Indian cities. Data revealed that Maharashtra was leading the daily tally of Covid cases, closely followed by West Bengal, Delhi, Karnataka, Rajasthan, Kerala and Gujarat. Dr Arora said most of the cases were asymptomatic or mildly symptomatic, just as it was observed in South Africa. He, however, emphasised that the people yet to be vaccinated should get the anti-Covid doses at the earliest and strictly follow the Covid-appropriate behaviour.
Indian Council of Medical Research (ICMR) additional director general Dr Samiran Panda told TOI that the active Covid curve would begin to flatten within three months in the areas recently registering the surge. “For this, people have to abide by the Covid appropriate behaviour and protocols, and act appropriately. The projection that we have generated so far through the modelling exercise shows that if Omicron is the dominant variant of the virus in an area, the surge in infections will sharply go upward and fall in three months,” he said.
The major metropolitan areas in the country have Omicron as the major variant of Covid. But in areas such as the North-East, it is more of the Delta variant that is causing stress on the health system. The country does not have a homogenous representation of the epidemic and states have to ready specific action after critically analysing their respective data,” Dr Panda said.
Dr Lalit Kant, another public health expert and infectious disease epidemiologist and senior advisor at Ashoka University told TOI, ‘Two things are notable about the Omicron variant. It is more infectious and transmissible than the Delta Variant. Prior infection provides poor protection in Omicron cases. The number of severe Omicron cases needing hospitalisation is around one fourth of the Delta variant infections.
He said, “The focus should now be on patient care and stress should be on tele-consultation centres. Experience from other countries show that it takes around 4-6 weeks for the Omicron cases to reach the peak and then there is a sharp fall. Accordingly, if we witness a peak of Omicron cases in early February, the surge may be over by the middle of March.”
Will Omicron infection give lifelong immunity to Covid?
As the Omicron variant blitzed through the word last month, some experts suggested it might turn out to be a good thing eventually. In their view it might do what vaccines and previous Covid waves could not-create a worldwide barrier for Covid’s spread and end the pandemic.
However, experts are not optimistic about it. The doubt whether in reality, Omicron boosts immunity. And even if it is true, nobody knows how long the effect will last. Another variant with multiple mutations could dodge the immune system like Omicron dodges Delta induced immunity.
In fact, a report from imperial college London last month estimated that, compared with the Delta variant, Omicron is 5.4 times more likely to infect someone who has had Covid before. And two vaccine doses could not prevent a mild infection in most cases (although protection against severe disease remained high.