INDIA ON GUARD
THE WEEK|April 25, 2021
THE SECOND WAVE OF COVID-19 CAUGHT US LACKING AND SLACKING. REINING IN A RESURGENT VIRUS WOULD NEED BETTER ADHERENCE TO SAFETY PROTOCOLS AND A MORE NUANCED APPROACH TO VACCINATION
REKHA DIXIT

Oorjita Lath had not stepped out of her Gurugram house or met anyone since mid-March. But on April 1, when vaccinations opened up for the 45+ age group, she went to a facility nearby to get her shot. A day later, she had fever, fatigue and aches that people said were known side-effects of the vaccine. When, five days later, her condition had not improved, she consulted a doctor through telemedicine, who recommended she get a Covid-19 test done. She tested positive. Subsequently, so did her husband and two daughters, all of whom are in home isolation, grappling with bone-breaking pain and fever. The doctor feels she picked up the bug from the vaccination centre.

Lath may have got the bug because the vaccine had not even had time to get cracking with producing antibodies. But across hospitals, doctors and health workers are testing positive in droves, despite having received both doses of the vaccine. A few had to be admitted, too, because of existing comorbidities. Reinfections in patients—around 1 per cent—may not be that rampant, but the numbers are enough to establish that acquired immunity does not last long. And at a time when fresh cases are rising, reinfections add to the load.

Then, there are patients returning to hospitals with complications developed as a result of the damage the disease wreaked on them. “We are seeing patients with lung fibrosis and kidney problems, all caused by their encounter with the virus,” says Dr Suranjit Chatterjee, Indraprastha Apollo Hospital’s senior consultant in internal medicine. By one rough estimate, 5 per cent of Covid-19 cases (which is a high number, say doctors) suffer from a condition called long Covid, which manifests itself in different ways—tremors even months after recovery, chest spasms, breathlessness, anxiety and erratic heartbeat. Not every doctor recognises that these are not just psychiatric issues that can be solved with counselling. The body, which had to go into fight mode to deal with the virus, produced adrenaline, and even months later, the adrenaline spikes continue. The treatment is through low-cost medication to counter the hormone, but it requires trained professionals to recognise this need.

Just when the nation was smugly patting itself on the back for having managed the pandemic rather well as compared with other countries, it resurged with a vengeance. Ambulance sirens have begun pealing again, almost continuously in some parts. Comparisons with other countries often do not give the full picture. So, saying India has surpassed Brazil to second slot with highest daily cases may have policymakers rushing with different explanations. Look at it this way: In barely a month since the second wave, India has already surpassed its own previous highs of daily new cases, and the dying continues at alarming numbers. Last year, it took four months into the “wave” for deaths to reach the highest toll of 1,114 on a single day (mid-September). This time, within two months of the surge, the single-day death count has crossed 1,000. Union Health Secretary Rajesh Bhushan was forced to admit that this was a cause for worry. While the death rate itself has not gone up—it is around 1 per cent as in last year—in sheer numbers it might increase as the caseload rises to new highs.

On April 13, Delhi alone reported 72 deaths and more than 13,000 fresh infections. Only a few weeks ago, its daily rise was down to two digits and there were days with no recorded deaths. During its worst time last year, the daily hike was below 9,000. Daily cases are increasing by over a lakh nationally, and we do not even know whether this is the crest of the wave, or if the peak is yet to come. “This virus is like nothing we have seen before,” says Chatterjee. In this fresh round, there are more symptomatic cases than asymptomatic, say doctors. And the below 40-population has been hit in a bigger way.

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