Tick-Tock Suspense In India Amid The COVID-19 Omicron Variant Scare!

Photo: jagran.com

The Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE) which is an independent group of experts that periodically monitors and evaluates the evolution of SARS-CoV-2 and assesses its specific mutations had convened a meeting on 26 November 2021 to assess the emerging COVID-19 variant B.1.1.529 that was first reported to World Health Organization (WHO) from South Africa on November 24, 2021. The epidemiological situation in South Africa has been characterized by three distinct peaks in reported cases, the latest of which was predominantly the Delta variant that originated in India. In recent weeks, infections have increased steeply, coinciding with the detection of B.1.1.529 variant.

This variant has a large number of mutations, some of which are concerning. Preliminary evidence suggests an increased risk of reinfection with this variant, as compared to other Variants Of Concern (VOCs). The number of cases of this variant appears to be increasing in almost all provinces in South Africa. Current RT-PCR tests continue to detect this variant, pending genome sequencing confirmation.

Based on the evidence presented which is indicative of a detrimental change in COVID-19 epidemiology, the TAG-VE has advised WHO that this variant should be designated as a VOC, and the WHO, on Friday, has designated B.1.1.529 as a VOC, naming it as Omicron.

Countries have been asked by the global apex health body to do the following:

1. Enhance surveillance and genome sequencing efforts to better understand the circulating SARS-CoV-2 variants.

2. Submit complete genome sequences and associated metadata to a publicly available database.

3. Report initial cases/clusters associated with VOC infection to WHO through the IHR mechanism.

4. Individuals are reminded to take measures to reduce their risk of COVID-19, including proven public health and social measures such as wearing well-fitting masks, hand hygiene, physical distancing, improving ventilation of indoor spaces, avoiding crowded spaces, and getting vaccinated.

This scary warning has rudely awakened India from a comfortable slumber registering today the lowest number of active cases in over one and half years, and declining daily infections with only the state of Kerala still showing high figures in both infections and deaths. This situation is significant, because it's now more than three weeks since the biggest festival of Diwali. But the fact remains that laxity creeps in during the festive season in terms of low rates of testing, surveilance and other regulatory measures that implies that the displayed figures may not represent the reality. The most well-known and prominent expert voice, Dr. Randeep Guleria (Director, AIIMS, Delhi), has recently said in his regular interviews to news channels that this time last year too was similar, and surge of infections was taking place in Europe, and then the Delta explosion happened in India. He stressed that preparedness must always be there as we've been again watching multiple surges in Europe at the moment including Russia in particular and the possibility of the much-discussed Third Wave is still lurking in India. Now, the Omicron threat has made the situation here like a lull before the storm. 

The Prime Minister of India, Narendra Modi, has responded immediately to WHO directions by holding a two-hour health preparedness meeting today morning. He has asked citizens to be proactive and follow all COVID norms. The Prime Minister requested the Aviation sector to review its decision to relax international air travel from December 15 this year and to test and quarantine all international travelers from countries at risk. He stressed upon the need to increase surveilance, strict containment in cluster infections and to ramp up genome sequencing, the same point being also raised by Dr. Guleria in an interview today. Modi also also asked for the full mobilization of the efforts by the states in a collective fight against the pandemic. Alerts have been issued to the health sector and the hospitals. 

The Omicron strain having more than 30 mutations within itself has already spread to countries like Belgium, Israel and Hong Kong. As it enters human bodies through the spike proteins it can be much more infectious and can evade vaccines or immunity. Almost all of the infected people in South Africa have got both doses of vaccination. However, enough data is still not there to say if this variant is deadlier than the Delta or if it can lead to severe disease, hospitalizations and deaths. As a hopeful development the Moderna vaccine producer has said that they can come ready with a booster dose in a few weeks' time to effectively tackle Omicron. 

Many European countries already under surges of Delta infections and having the irony of facing protest-demonstrations against COVID controls, and the US have started imposing travel restrictions for South Africa and other African nations. So then, it is tick-tock suspense on the future course of the pandemic in a relaxed and election bound India. Indian citizens including the politicians and the leaders themselves would be better advised to not let down their guards and follow all norms as sincerely as possible. Another disaster like the Second Wave must be avoided at all costs. One must understand the COVID-19 virus is not going to give up easily even after nearly two years, and on the contrary, this virus is busy adding more ammunition to its armour to go on launching merciless assaults on humankind. In Karnataka, there are cluster infections in students after the reopening of educational institutions and most of the infected have been double-vaccinated. It is imperative now to genome sequence their samples as intensively as possible. 

Vaccination of the under-18 should also be given the highest priority. 

 

India Register The Lowest COVID-19 Daily Cases In Six Months As The Festival Season Looms Ahead!

For the last 3-4 days India have been registering less than 30,000 daily COVID-19 cases with daily fatalities also reducing. A lot of hope is being generated now as the country has seen less than twenty thousand cases in the last 24 hours, 18,795 to be exact, which is the lowest in six months, and the daily deaths have also come down to 179 fatalities in the same period. The state of Kerala is still leading, but the daily infections that had reached more than thirty thousand recently are 11699 in the last 24 hours and the daily fatalities that had overtaken Maharashtra crossing the 200 mark have come down to 58 in the same period. Maharashtra, the worst affected state in India with over 6 million total infections, has also registered less than 3000 cases in the last 24 hours which is the lowest since February 2021 and the deaths at 32 during the same period. Only two other states, Tamil Nadu and Mizoram, are still showing a rising trend of daily cases; all of the rest of India seem to be doing well in all respects: as per a recent report of the Government of India the positivity rate is over 5% in only 23 districts of the country.

 

To add to the positive scenario the country has crossed the required 10-million mark in daily vaccine jabs for the 5^th time—recently crossing the unexpected 20-million mark on the Prime Minister Narendra Modi’s birthday. However, to achieve the target of vaccinating the whole country by  December this year the rate needs to be sustained consistently on a daily basis, rather than concentrating on special days to jack up the jabs just to please the authorities examples of which could be seen in the recent past too. No doubt, the Government has been trying very hard to improve its image after the disastrous handling of the Second Wave of the Pandemic that killed hundreds of thousands of infected people, but the realities must be faced at all times in a totally non-political way. If the second wave is finally concluding the Government must ensure that the much-feared Third Wave is never allowed to take off. More than 80% of the country’s population has been given at least one jab; but the India-made Covaxin is yet to be approved by the World Health Organization for emergency use, particularly in light of the restrictions imposed rather irrationally by the United Kingdom for Indian travelers. 

There are various concerns though about the future course of the pandemic in India and if it can be controlled till early part of 2022 then only we too can be sure of being able to shake off the third wave and being assured by the ‘endemic theory’ that effectively ruled out further countrywide spread of the virus. Buoyed by the less than 5% positivity rate seen in most parts of the country, the speeded up vaccination and a new vaccine for children above the age of 12 to be available anytime soon, the states are opening up almost completely, this is being endorsed by the experts too. Quite a few of them have reopened schools and colleges and the worst-affected Maharashtra has also decided to reopen schools from 22^nd October and also reopen cinema halls/auditoriums from the same date. This combined with the looming festival season that would last till February 2022 poses as the biggest challenge for the fight against COVID-19. This is indeed going to be the litmus test. The Government of India has sounded restrictions in crowding, particularly in Durga Puja pandals, in districts where the positivity rate is still higher than 5%. However, considering the extended festivities to come we cannot rule out or be complacent about possible exponential rise again in the other states too. Therefore, the overwhelming needs remain to be strictly following COVID appropriate behaviour, avoiding big gatherings/parties and staying away from unnecessary travel or pleasure trips. The next 3-4 months are going to be crucial.

India’s COVID-19 Situation: A Crucial Juncture!

The largely preventable or at least controllable marauding second COVID-19 wave in India seems to be ebbing with around 39000 new infections in the last 24 hours and around 700 fatalities in the same period. However, the crisis is far from over with the spree of unlocking taking place all around the nation and the most feared third wave lurking somewhere in the corner. Most of the places except for educational institutions and cinema halls have been reopening in most of the states, with only containment zones still put under strict restrictions. The grim milestone of deaths at over 4 hundred thousand has also been reached with at least two hundred thousand extra fatalities suspected. Further, unlocking cannot be avoided indefinitely due the issue of livelihoods, and in light of the fact that the national positivity rate is now around 2.5% unlocking is technically justified. However, the state governments of India must display extreme caution and aggressive testing, tracing and containment. 

 

Now, the main problem that occurs due to unlocking is the growing COVID inappropriate behavior of the people: social distancing in most Indian markets or in public places is practically impossible, but at least compulsory masking and hand hygiene must follow which, unfortunately, gets forgotten or neglected. With the devastatingly infectious Delta variant still dominant in the country and spreading across the globe it takes little time for another deadly explosion of infections. Besides, there is one more variant called the Delta Plus which could become a cause of concern sooner than later. Then there are the other terrors of black fungus, supplementary infections in hospitals and the long COVID syndrome.

 

In such a situation vaccination becomes the only option for some protection: experts have been maintaining that although the vaccines—three in India at the moment, namely Covishield, Covaxin and the Russian Sputnik V—cannot guarantee full protection against infections these have been proved to provide protection against the severe form of the disease and hospitalization or possible deaths. Unfortunately, India has been infested with the vaccine shortage problem when the doses were desperately needed. The Government of India has been stoutly denying any such shortage consistently the superficiality of which claim has been exposed many times with many vaccination centers closing down across the nation and huge rushes in the existing centers.

 

We can see in the photographs in this piece the rush for jabs in a walk-in center in Kolkata. In fact, such huge gatherings for jabs can be a great risk for infections. Besides, there are several vaccine frauds taking in various places including Mumbai and Kolkata that hardly help matters. We hope the Government of India would, as promised, regularize supply of vaccines from July 2021 and complete vaccination of all target age groups by December this year. Accelerated vaccination is the primary hope of reducing human sufferings if the third wave happens to strike.

 

Of course, there are some hopeful indications too. The COVID-19 national expert panel, severely criticized for keeping mum about the gnawing second wave since March this year, has maintained that if the third wave indeed strikes the cases are likely to be half of that in the second wave. Secondly, as per historical evidence the second wave of any pandemic or epidemic normally wreaks the greatest havoc on humans. Therefore, the third wave may not be as deadly as feared. Lastly, some medical experts believe that as a virus keeps on mutating to develop vaccine resistance or breakthroughs it keeps on getting weaker and weaker, and in the process it stops impacting human lives at some period of time. We hope that period happens now and humankind manages to throw off the greatest curse to have befallen on them in its entire history. 

India COVID-19 Vaccination 2.0: Jabs Set To Accelerate With Private Participation!

The first phase of COVID-19 vaccination in India that started from the 16^th of January 2021 aimed at inoculating around 30 million healthcare sector and frontline workers. Although so far only about half of that target and less for those having double doses has been achieved the Government of India, under pressure to speed up the process allowing participation of the private sector and also in view of the surge in new infections in several states, has decided to usher in the second phase of vaccination that aims at administering the jabs to senior citizens above 60 and people above 45 years of age with comorbidities; as per the earlier estimates this target population will be around 270 million which, of course, targeted all people above 50 with or without comorbidities. The policy decision to allow the private sector come into the picture is the welcome change in Vaccination 2.0 which is bound to accelerate the number of jabs administered, and the process begins from tomorrow, the 1^st of March 2021 all over the country.

 

Around 20,000 private hospitals across India start administering the jabs from tomorrow under payment basis, the price per dose of vaccination being capped by the Government at Rs. 250/. More than 10,000 government hospitals/health centres will continue vaccinating free of cost. As has been decided earlier people will not be able to choose the vaccine, between Covishield (Indian version of the Oxford-AstraZeneca) and the indigenous Covaxin both of which have been declared as fully safe.

 

The process of registering or getting appointment for vaccination has been made easy: people will be able to register from their mobile phones on the recalibrated Co-Win app to be launched from March 1, and also on the Aarogya Setu app; they will have to fill up a simple form uploading documents in support of identity and age, and can get up to four appointments at the centres of their choice from the same mobile; people above 45 with comorbidities will have to upload a certificate from their doctors apart from the identity and age-proof documents; this process of registering can also be done at the website www.cowin.gov.in ; if some senior citizens are not techno-savvy they can either visit a registration center with the required documents to fill up the form or even can use the option of ‘walk-in for vaccination’ depending on availability of slots.

 

The Government of India has already dispelled misgivings about the related Apps of Co-Win and Aarogya Setu saying that everything has been updated and it would be a hassle-free experience for all from the target date of 1^st March 2021. We hope this turns out to be the case in actual practice, and that considering the worldwide phenomena of the vaccines having some adverse events in very elderly people and people with certain medical conditions like allergy the doctors would guide them adequately for getting inoculated. It must also be ensured that the vaccination centres do not become super-spreaders in themselves as pointed out by experts.  

 

Meanwhile, the rise in new COVID-19 infections continues unabated in Maharashtra with cases more than 8000 a day for the last four consecutive days. Lockdowns, partial lockdowns, night curfew and other curbs have been in place in several affected districts of the state. Chief Minister Uddhav Thackeray’s deadline of 8 days for the people of Mumbai ends tomorrow, and with new cases hovering around 1000 daily in the financial capital the decisions of the state government is eagerly awaited. While a pure lockdown in Mumbai would greatly hamper the progress made in the last two-three months strict enforcement of other curbs could be an option. In Kerala, although new cases have been declining, the situation is still far from satisfactory, and spikes have also been noticed in other states like Karnataka, Gujarat, Madhya Pradesh and Punjab. However, Vaccination 2.0 should be welcome news for all of these states too. And of course, the widespread phenomenon of Covidiots must be kept under absolute control. 

COVID 19: Now The ‘Doubt Virus’ Must Be Exterminated!

Common people mostly have fickle minds; they are always guided by what they want to believe, often to their advantage. When they are worried, frightened and clueless about the future they are most vulnerable to doubt and conspiracy theories. For the last six months people all over the globe are very disturbed by the COVID 19 pandemic, not so much because of the deadly effects of the virus than the restrictions and lockdowns derailing normal life it has brought in its wake. They desperately need to go back to the sweet normal times and live happily ever after, and therefore they jump to accept and believe fully when some motivated souls offer that ‘COVID 19 is a hoax, it’s nothing more than an annual influenza’. Thus the ‘doubt virus’ is created and the social media as always helps it spread—at times much faster than the killer virus. Perhaps the basic impulses for skepticism stem from the facts that more than 80% of Coronavirus positive cases are mild in nature and recover easily, only the elderly with comorbidity are most vulnerable and that on average the death rate is low at 1 to 4% except for some countries. However, facts also show that the dead includes young people too and anyone can be infected by this most contagious virus.

The conspiracy theories originated in the United States, as always, where extraordinarily ‘democratic’ sections of the citizens opposed the lockdown and restrictions from the beginning symbolizing these with the ‘agenda’ of President Trump. Several conspiracy theories linking even the tragic murder of George Floyd started doing the rounds in the US of which we will not make a description here just to prevent vulnerable minds go through and inculcate doubts. We’d only like to mention here that this writer got a social media forward giving a link to an article by some ‘enlightened soul’ who took pains of great arguments to ‘prove’ that the pandemic is a ‘political hoax’. As we mentioned earlier a lot of vulnerable people got influenced by this, and none other than a medical surgeon of the Indian state of Assam who even lodged a FIR alleging that only an ‘annual influenza’ has been labeled as a pandemic and he wanted action against the concerned governments. This, naturally, created a chain of reactions in the state driving news channels asking the hapless common people about their ‘doubts’ on the COVID 19 infections rather than destroying the dilemma.

Now, this ‘annual influenza’ theory breaks down at the basic premise itself: if that is so then this phenomenon must be occurring every year, and why then this year should be so different! Governments need not have gone on an emergency drive to create more and more healthcare facilities including ICU beds just to tackle an annual event of flu. Then come the experiences of various affected countries and governments tackling this ‘annual influenza’ some of which we narrate below as arguments to break such kinds of fake and motivated views:

1.     Let us take the example of the Chinese experiment. Ignoring a lot of conspiracy theories about China itself we just ask here why would China need absolute authoritarian measures to tackle the virus (well, even annual influenza is caused by a virus) in terms of continuous lockdown and rigorous enforcement. After being successful in keeping the infected numbers below 100,000 the country is still fearing a second outbreak, and risking its economic downswing again to prevent its spread. Its aggression against India can also be explained as a part of its apparent desperation. An annual flu cannot explain these.

2.     Why would countries like UK, Italy, Spain, France, USA and Brazil suffer so much from an annual influenza that killed more than half a million so far and is still on its deadly prowls? Why would Italy reduce itself to a state of  helplessness with dead bodies of Corona patients littered everywhere or why would  German finance minister commit suicide over Corona worries? How one is to account for a death rate of over 14% (seen in a few countries) for an annual influenza virus?

3.     Why would the doctors and experts of the World Health Organization keep on telling ‘lies’ that the new Coronavirus is very dangerous that would probably stay for more than two years and the worst is yet to come despite whatever campaigns or actions going on or taken against it? We seemed to have accepted in the beginning that this pandemic is the biggest crisis ever faced by humankind. Now, why have second thoughts and doubts?

4.     Why would countries across the world keep on taking huge risks for an economic crash with unprecedented unemployment and pave the way for a recession possibly even worse than the Great Depression? In particular, why a developing country and a most promising upcoming world power like India should risk whatever it has achieved in development so far.

5.     Why is such a mad rush all over the globe to fast-track production of a vaccine against only an annual flu? At least such an intensive medical research cannot mask a hidden agenda whatever that may be.

In the last twenty-four hours new cases in India have crossed 22000 with the only solace that daily recoveries are more in numbers and death rate is fortunately still low; the concern being a rising positivity rate indication community transmission. At this crucial juncture we should not pay heed to conspiracy theories and fake news. Such theories have obvious goals: to generate publicity for unknown groups or to make a kill in terms of profit. For example, if a link for an article with sensational and terrifying headlines gets circulated across social media and motivated media outlets think of the kind of clicks being generated which directly translate into money.

Therefore, we must not fall prey to such propaganda at any cost. It is heartening to see that several social media platforms have taken steps to neutralize the conspiracy threads.  In relation to India, we need to say here that the government should find time to brief the media frequently as it had been doing earlier to describe facts and quell doubts instead of crouching behind the rising numbers. Similarly, most respected bodies like the Indian Council of Medical Research (ICMR) should desist from publicizing dates for production of vaccines. The announcement by the ICMR that a vaccine might be made possible by 15^th of August 2020 has furthered the doubts already created with even sensible people and the media asking why should the ICMR be in such a hurry. The mantra at this hour must be to fight the killer virus with the combined might of the world and to defeat it preventing its possible second wave. 

COVID And Amphan: Indian Contrasts In Crisis Times!

When the extremely severe cyclonic storm Amphan hit Kolkata and adjoining districts of West Bengal in the evening of 20^th May, 2020, with a speed ranging from 110 to 133 km per hour the damage could very well be anticipated. West Bengal is not new to cyclones originating in the Bay of Bengal, in fact, three cyclones namely ‘Fani’, ‘Bulbul’ and ‘Amphan’ swept over the state within a span of one year only—from May 2019 to May 2020. However, the force and speed of Amphan was unprecedented in the state as some point out that the areas had not seen such a severe cyclone in 283 years. By late night that fateful day, closeted in the control room of her secretariat in Howrah, Chief Minister Mamata Bannerji, distressed and sad, said while briefing the media online that a few districts of her state and Kolkata were totally destroyed and it would take days to assess the damage apart from the loss of lives. She desperately hoped that the central government would come in with some help as her state was already drained of resources with the battle against COVID-19 raging on. Didi, as she is popularly known, also hoped Prime Minister Modi would come and see the damage for himself. And, the Indian Prime Minister responded magnanimously, announcing the very next morning his decision to visit the state on 22^ndMay.

Political differences between BJP-ruled central government and TMC-ruled West Bengal state government are only too well known with both parties not stopping the rivalries and the parleys even during COVID times, in fact, fighting over COVID issues in recent days. Therefore, Mamata wishing for Modi’s presence and Modi’s gesture in coming immediately is being viewed in a new light: that they have come together in a spirit of cooperation in the time of crisis, setting aside politics for the moment. The Prime Minister expressed full solidarity with the state government—hit by twin-tragedies, and praised its efforts in tackling both the catastrophes. He assured full help at every step of the way ahead—restoration, reconstruction, rehabilitation and the like, and announced a preliminary financial package for immediate expenses.  Later in her media brief at the airport after seeing off the Prime Minister, Mamata Bannerji appreciated Modi’s visit and his promise of joint efforts, not saying anything against the offer of help as claimed by a ‘national’ news channel that started carrying supers ‘Mamata Slams Aid’.

Unfortunately, Maharashtra wing of the BJP failed to learn any lesson from its central leadership bonhomie, and selected this same say to stage public protests all over the state claiming the state government’s mishandling of the COVID fight, perhaps the very first instance of such kind in the worldwide war against the killer virus. One of their allegations, as puerile as it sounded, was that why Maharashtra has witnessed such a spike in cases while Kerala handled it so competently. Well, ‘serving’ the interests of the local people for decades they still don’t understand why Mumbai is Mumbai, and why it should have the largest number of COVID-19 infections, like, in a similar way, why the virus should select New York for its special treatment. In totality, they must understand that COVID is not a political phenomenon and doesn’t go by who ruled which state. At this hour of crisis for the state the best option for them is to inspire the people to follow the precautions religiously and to jump in the fray for total cooperation. Perhaps, in India, political parties need multiple tragedies strike in unison to make them lose their political rivalries and power-hungry politics, even if for the time being.