Will China Covid surge lead to Delta-like wave in India?

China is breaking all previous covid records with a fresh surge of cases that has all but dismantled its health infrastructure. The spread is believed to be triggered by the BF.7 subvariant of the virus, which is said to be the most infective. A few cases of the same variant have also been found in India. So, are we staring at yet another devastating wave of Covid? Are we prepared enough to save ourselves? What measures do we need to follow in order to pre-empt a possible spread in India? To answer all these questions and more, we have with us Dr K Srinath Reddy, an honorary distinguished professor at the Public Health Foundation of India. A senior cardiologist, his outstanding contribution to public health has earned him a Padma Bhushan, apart from several other prestigious honours. Will China Covid strain bring about Delta-like wave in India? Dr Reddy says it depends upon what we call a wave. If we are talking in terms of infections, like minor colds or even transient fever, then we may see a rise in cases. But if we are talking about a wave in terms of serious infections, landing people in hospital, rushing them to intensive care and unfortunately resulting in their demise, then it’s extremely unlikely that we will see such a wave. By no means are we likely to see the Delta wave being replicated. Possibly some version of the January 2022 Omicron wave could come in, stresses Dr Reddy, but that too is likely to be of a lower magnitude.Do we need more genome sequencing to detect mutations and be battle ready?It is important for us to increase our genome sequencing, feels Dr Reddy, because we must find out about the cases in India, whether mutations are actually occurring even inbred within our own country. After all, Delta emerged from within India. The greater danger is whether the variants coming in from outside could trigger off an uptick in our cases and possibly could be even serious if it is a dangerous new mutant, not just the omicron family of variants.So, it is important for us to increase our genome sequencing. However, we must also recognize that there will be a number of people who are unlikely to be tested. And so, we have to keep a watch on that as well. Do we need to test more people with symptoms?Dr Reddy says that we know for sure that testing is needed in order to identify cases and advise isolation at home or, if serious, transfer to the hospital. However, that itself is not going to be adequate for several reasons because tests have false negatives as well.In fact, the false negative rate is likely to be higher with the newer type of Omicron variants. We also know that the tests can be negative early in the infection and late in the infection. And unless repeated tests are done, you may not be able to capture the virus. And we do know that many people do not even get tested if they’re minimally symptomatic or asymptomatic.So, the important thing is for us to test whenever possible, but also tell people that if they have cold-like symptoms, a bad cough or are running a fever, they should self-isolate at home. So, symptom-based identification of cases is also important, not just depending on test results alone, whether for self-quarantining, self-isolation, or even in terms of ensuring that people are not mingling in large crowds or in office spaces.Will more booster doses help us fight better? In India, the situation has been slightly different because, apart from the two doses of the prescribed vaccine, many people have also been infected with the virus either before or after vaccination, particularly during the Omicron wave. And that itself might have acted as a booster in terms of the immune response. But if people are eligible for a booster, they should certainly take it and not avoid it. Whether a fourth dose is required is debatable. For people who are in the elderly age group, people who have severe comorbidities, and particularly for people who are immunocompromised, an additional is likely to be helpful. A matter of concern is whether the Omicron new variants in particular are likely to be far more immune evasive. Even if that were so, a surge in antibodies could still immobilize the virus and some residual T-cell immunity, which may not be detected immediately, may also surface in order to capture and kill the virus. So, for people who are vulnerable, an additional booster dose is likely to be helpful, but not necessary for everybody. What other covid appropriate behavior do we need to follow? Keeping the virus out of our respiratory tract is most important because we cannot depend upon the currently available vaccines to do that, warns Dr Reddy. The vaccines help us not get seriously ill and land up in hospital, but they do not prevent the virus from gaining entry and settling down for some time in our upper respiratory tract. So, we do need to wear masks in order to prevent that. The second thing, of course, is to ensure that we move as much as possible in ventilated spaces, whether at home or outside, and particularly in offices and other places where we work or study. Ventilation is absolutely critical because it doesn’t allow viral clouds to form. The wind dissipates viral clouds.The two things that have been really protecting us in terms of Covid are vax in and mask up. So, caution is required. We need to be on alert, but certainly not be alarmed.Audio production: Sahil Gupta