Covid-19 In India: What The Current Spike Means And How To Avoid A Fourth Wave

India has been seeing a slow increase in the number of Covid-19 cases across certain states including Maharashtra and Delhi. The statistics have caused concerns among authorities regarding the approach of a fourth phase of Covid-19, driven by Omicron subvariants. 

Maharashtra, Kerala, Delhi, Karnataka, Tamil Nadu, Haryana, Uttar Pradesh, Telangana, West Bengal, Gujarat, Goa and Punjab have been recording an increase in weekly cases and positivity since June 10.

According to official sources, 51 districts in India, including 12 from Kerala, seven from Mizoram and five each from Maharashtra and Assam, are reporting a weekly Covid positivity rate of over 10 per cent.

In 53 districts, including 10 from Rajasthan and five from Delhi, the weekly positivity is between five and 10 per cent

However, there are ways to avoid a fourth wave and a rise in cases may not necessarily be a cause for concern yet.

Understanding the rise and fall in Covid-19 cases

Rise and fall in cases from time to time is a common phenomenon when an infectious disease transitions from pandemic to endemic phase. Dr Sanjay Rai, a senior epidemiologist at AIIMS, said SARS-CoV-2 is an RNA virus which has already seen over 1,000 mutations even though the number of variants of concern are only five. 

Even in the case of Omicron variant, mutations happened in the receptor binding domain which increased the chances of reinfection and breakthrough infections. 

The trend of cases rising repeatedly is a "common phenomenon" when a disease transitions from pandemic to endemic phase, Dr Rai who is also the principal investigator of Covaxin trials for both adults and children at AIIMS, told PTI.

As long as there is no increase in severity or dramatic changes in hospitalisation and death numbers, sheer increase of cases is not a cause of concern, he said.

Localized spikes not a big threat

Experts also underlined that the spike in cases is being driven only by numbers rising in certain pockets or districts and not strictly at a national scale. 

According to Dr Samiran Panda, Additional Director General at ICMR, the spike in cases remains restricted to certain pockets in districts and cannot be seen as a general rise in infections for the entire district or state.

Infectious diseases expert Chandrakant Lahariya adds that "it is fair to conclude that COVID-19 is not a population level challenge anymore, it is more of an individual risk now. Therefore, government interventions should be more targeted at vulnerable people. It is time individuals assess their risk and determine what Covid appropriate behaviour they wish to adopt". 

Covid-appropriate behaviour

This brings us to the next point - what is Covid-appropriate behavior now, 27 months into the Covid-19 pandemic? And can following such protocols help prevent a fourth wave? Experts think it can. Here are some of the tips they suggest that Indians can follow at an individual level irrespective of where they are to prevent another outbreak:

Wearing masks: From the beginning of the pandemic, the humble face mask has been hailed as the first and often the most important layer of protection individuals have from SARS-CoV-2. Scientists and doctors continue to encourage all to wear masks, especially those who are vulnerable to severe infection such as children, the elderly and those with previous health conditions or comorbidities. Wearing masks not only protects the individual from contracting the virus but also prevents him from becoming a carrier of the virus. Humans can transmit Covid-19 even if they themselves do not get affected by it. 

Hand-washing, maintaining hygiene: Much like wearing masks, these golden rules continue to apply when it comes to keeping Covid-19 at bay. Regular handwashing is the primary barrier against multiple infectious diseases including Covid-19. 

Taking care of ventilation, social distancing: Covid-19 pandemic has taught the world the importance of properly ventilating homes and public congregational spaces like office quarters, schools, gyms, auditoriums etc. Covid-19 circulates through the air and closeted spaces have the potential to trap the virus for longer. In spaces where natural ventilation is not an option, use of artificial air filters such as the HEPA accredited filters used for reducing air pollution can also be used as an alternative. Maintaining proper social distancing in crowded spaces is equally important. 

Vaccination and natural immunity: Global evidence show that natural infection provides better and longer protection against COVID-19. Also, there has been a high vaccination coverage. Hence, a severe wave in the future is unlikely until a new mutant variant is capable of invading the existing natural immunity and causing severe disease. Researchers agree that taking booster doses can help in reducing the possibility of future breakouts driven by subvariants. 

Dr Anthony Fauci, the top infectious disease expert in the US, recently said that his COVID-19 recovery is an “example” for the nation on the protection offered by vaccines and boosters. 

Fauci, 81, said he began experiencing virus symptoms on June 14 and tested positive a day later.  “I'm vaccinated. I'm doubly boosted. And I believe if that were not the case, I very likely would not be talking to you looking as well as I look, I think, right now," he said.

While the research on the Omicron variant is emerging, several studies have estimated the effectiveness of various vaccines used around the world against the Omicron variant and found differing results. But researchers agree that two doses of vaccine increase the body's immunity against severe disease and hospitalisation and additional booster doses could be key to avoiding a sever infection by Omicron or its sub-variants.

Travelling with care: A recent spurt in travel after governments ease Covid-19 restrictions has also been attributed to the spread of Covid-19. This mandates the need for more care while travelling. Since the virus is still around, it is best to travel infrequently and avoid crowded tourist places during peak season. Travel should be avoided in case one is feeling any of the symptoms associated with Covid-19. Maintaining proper Covid-19 appropriate behaviour when travelling is a must and can save lives.

(With inputs from PTI)